Background <p>Nasal dorsal hump is a common aesthetic problem with various approaches to manage. This study aimed to evaluate the subjective and objective aesthetic outcomes, surgical outcomes and quality of life of patients after endoscopic assisted push down dorsal preservation rhinoplasty (DPR) with sideways U-shaped septal resection.</p> Methods <p>The present study was a prospective cohort study including 30 patients who were assessed preoperatively and postoperatively using a validated Arabic version of standardized Cosmesis and Health Nasal Outcomes Survey (SCHENOS scores), Rhinoplasty outcomes evaluation (ROE), an Arabic version of Rosenberg Self-Esteem Scale (RSES) and aesthetic measurements including length, projection and angles.</p> Results <p>The study showed a significant postoperative decrease of all parameters of SCHNOS score (p value &lt; 0.00001), significant postoperative increase of all parameters of Rosenberg Self-Esteem Scale (RSES) (<i>p</i> &lt; 0.001). and a significant change between preoperative and postoperative Rhinoplasty Outcomes Evaluation total score (p value &lt; 0.001). There was a highly significant increase in the postoperative nasofrontal angle, and decrease in the postoperative naso-tip angle, radix projection and hump height ( <i>P</i> &lt; 0.00001) while There was a non-significant change in the nasofacial angle, nasolabial angle, nasomental angle, nasal length and tip projection.</p> Conclusion <p>The proposed technique as a method of dorsal preservation rhinoplasty has provided acceptable results with a significant improvement in subjective patient satisfaction, quality of life and objective nasal measurements. It is ideal for a patient with a non-crooked straight over projected dorsum. The use of endoscopy offered improved visualization, meticulous dissection and controlled modifications of nasal structures.</p> <p> Level of Evidence: Level IV, therapeutic study.</p>