Septoplasty is an important procedure but associated with much controversy, especially with regard to patient selection for surgery. It is also one of the first operations that many ENT surgeons will learn, but with variable understanding and training. The techniques of septal surgery have been modified over the years and include a standard method, external open septoplasty and more recently endoscopic techniques. In this chapter, the relevant anatomy, clinical assessment, surgical technique and complications will be discussed as well as a review of the outcomes associated with septoplasty. Summaries of the recent systematic reviews and randomised controlled trials that consider the safety and efficacy of this operation will also be described.