Objectives: To compare the efficacy and safety of high-intensity focused ultrasound (HIFU) therapy with coblation for the treatment of inferior turbinate hypertrophy (ITH).Methods: In this randomized controlled clinical trial, a total of 20 patients underwent inferior turbinate surgery, which consisted of either HIFU or coblation therapy. Efficacy, safety and tolerability were evaluated by subjective symptom scores, acoustic rhinometry, and nasal endoscopy.Results: The modified nasal obstruction symptom evaluation (NOSE) score and nasal obstruction visual analog scale (NO-VAS) were significantly decreased in both groups 12 weeks postoperatively. Differences between the evaluation scores of the two patient groups were not significant. On nasal endoscopy, the HIFU patients showed improvements in mucosal swelling sooner than the patients undergoing coblation therapy. Nasal crusting was significantly increased in the patients undergoing coblation over the patients undergoing HIFU therapy, until postoperative week 4. Mucosal preservation was superior in the HIFU patients. Although HIFU was less painful than coblation therapy during the procedure, the difference was not significant (4.9 vs 6.3, p=0.143). The difference between global satisfaction in the two groups was not significant, although satisfaction was slightly greater for the HIFU than the coblation patients (4.6 vs 4.1, p=0.393).Conclusion: HIFU provided results similar to those of coblation therapy for patients with nasal obstruction due to ITH, but HIFU therapy caused less discomfort during the procedure. HIFU therapy appears to be a good noninvasive alternative to the current surgical modalities for ITH.