This is a retrospective review of data of 70 patients who underwent endoscopic nasal septoplasty . The case records of 70 patients who underwent endoscopic septoplasty during the period from January 2009 to December 2011 at the Saudi German Hospital, Aseer Region, Kingdom of Saudi Arabia were reviewed. Patients had septal deviation and symptomatic nasal obstruction for at least 3 months, and medical management had failed. Preoperatively, nasal endoscopic findings were septum deviations (34 patients, 48.6%), spurs (30 patients, 42.9%) and septum deviations + spurs (6 patients, 8.6%). The most common presenting symptoms were nasal obstruction (55 patients, 78.6%), headache (42, 60%) and posterior nasal discharge (34, 48.6%), which improved significantly postoperatively. After the end of the follow up period of 6 months, there were no recorded immediate or late postoperative complications among all patients. Endoscopic nasal septoplasty is an effective technique that can be performed safely with a significant postoperative improvement in patient’s symptoms and minimal or no postoperative complications.