Background: Epistaxis is a common emergency, particularly in the context of trauma. Understanding patterns and outcomes of epistaxis in a trauma setting can inform treatment strategies and improve patient care. Objectives: To evaluate the demographic characteristics, clinical features, and outcomes of patients treated for epistaxis following trauma. Methods: This retrospective case-control study included 1106 patients from the National Trauma Data Bank diagnosed with trauma-related epistaxis. The clinical outcomes assessed included hospital stay duration, complication rates, and mortality. Results: In comparison with younger patients, older patients were found to undergo operative intervention significantly more frequently (median age, 65 years vs 44 years; P < .001). The prevalence of cardiovascular and psychiatric comorbidities was higher in the operative group ( P = .004 and P = .041, respectively). Mortality risk was not found to be independently influenced by epistaxis management approach. Conclusions: In older individuals with comorbid conditions, trauma-related epistaxis is more likely to result in operative intervention and associated complications. Nonetheless, the management of epistaxis does not appear to have a significant impact on mortality risk.