Objective To determine the effi cacy of intravenous dexamethasone in reducing postrhinoplasty edema.Design A prospective, randomized clinical trial with placebo control.Setting Department of Otorhinolaryngology, Al-Sabah and Zain Hospital, Kuwait.Subject Eighty-four patients (male = 28; female = 56) aged between 20 and 40 years, undergoing open rhinoplasty with hump removal and bilateral lateral osteotomies were enrolled in this study.Intervention Patients were randomized to receive two doses of 10 mg of dexamethasone intravenously or placebo, fi rst dose during surgery and second dose 12 hours after surgery. Main outcome measuresPatients were evaluated postoperatively at 24 hours, days 2, 5, 7 and 10 for periorbital edema.Results 10 mg of dexamethasone given intravenously during rhinoplasty and a second dose 12 hours after surgery, reduced postoperative periorbital edema signifi cantly.Conclusion This study showed a statistically signifi cant benefi t of dexamethasone over placebo in reducing periorbital edema after rhinoplasty. No complications were attributed to the administration of dexamethasone.