Background <p>Rhinogenic Contact Point Headache (RCPH) is a secondary headache caused by mucosal contact points within the nasal cavity, often refractory to medical therapy. This study aimed to evaluate the effectiveness of surgical management in reducing headache severity and impact in patients with RCPH.</p> Methods <p>A prospective observational study was conducted on 54 patients diagnosed with RCPH. Baseline demographics, headache characteristics, and anatomical variations were recorded. Patients initially underwent conservative medical therapy for four weeks, followed by surgical intervention in refractory cases. Outcomes were assessed using the HIT-6 and VAS at baseline and 8 weeks post-surgery. Statistical analysis was performed using paired t-tests, with p &lt; 0.05 considered significant.Results: The mean age was 33.02 ± 9.64 years, with 51.9% males and 48.1% females. The periorbital region was the most common headache site (68.51%). Major anatomical variations included septal spur with deviated septum (27.78%), concha bullosa (25.93%), and deviated nasal septum (20.37%). Medical management showed no significant improvement (p &gt; 0.05). Conversely, surgical management resulted in a significant reduction in headache severity and impact, with both HIT-6 and VAS scores improving across all anatomical variations (p &lt; 0.001).</p> Conclusion <p>This study signifies the importance of accurate identification of anatomical variations causing intranasal mucosal contact points and early surgical interventions are crucial to improving quality of life and reducing the chronic headache burden.</p>