Nasal septum deviation is a common deformity that can significantly impact a patient’s quality of life. The most common symptom is nasal obstruction, which can vary in severity among individuals. The extent to which nasal septum deviation contributes to overall obstruction can be assessed during a physical examination with vasoconstriction. It’s common to find mucosal hypertrophy of the inferior turbinate on the non-deviated side due to compensatory mechanisms. The most common surgical approaches in septoplasty are hemi-transfixion and Killian incisions. In cases where bilateral mucosa tearing occurs during mucoperichondrial flap elevation, an interposition graft should always be considered. To achieve a good cosmetic and functional outcome, it’s crucial to conservatively resect only deviated spurs and open the nasal valve. However, septoplasty can have complications. Persistent, subjective, postoperative obstruction is not uncommon among patients and is often due to inappropriate surgical indications. The percentage of dissatisfied patients can be reduced with optimal techniques and accurate preoperative diagnosis. Inferior turbinate hypertrophy due to allergic rhinitis or other factors can significantly affect the normal airflow of inspired air, and septoplasty alone may not provide a satisfactory outcome. Objective measurements like acoustic rhinometry or airflow rhinometry can objectively assess the need for surgical management.