Background: Septum deviation is the major cause of nasal obstruction, which is the most common symptom in ENT practice. Surgical correction of the deviated nasal septum has been advanced over the years, from the radical removal of both mucosa and cartilage to submucous cartilage resection with preservation of the mucosa. Objective: To compare the efficacy of the conventional and the endoscopic septoplasty in the management of patients with symptomatic nasal deviation. Patients and methods: This study included 40 patients presented to the Otorhinolaryngology outpatient clinic at Assiut University Hospitals between May 2018 and December 2019, suffering from nasal obstruction due to a significant septal deviation, randomly divided into two groups: Group A: 20 patients underwent endoscopic septoplasty and Group B: 20 patients underwent conventional septoplasty. Results: In this study, no significant difference was detected in the preoperative results of both groups regarding the age, sex and types of septal deformities. So, the preoperative circumstances were similar between both groups. Hence, results of this study showed that these two procedures were suitable to correct septal deformities but the endoscopic septoplasty was superior to the traditional septoplasty in cases with isolated septal spur. Also, it was associated with the minimal re-occurrence rate. Conclusion: Endoscopic septoplasty is a valuable teaching tool, which is efficient in the management of different types of septal deformities.