From January 1, 1991, to June 30, 1992, 18 patients were identified as having rhinologic sources for their primary symptom of facial pain or headache. These 18 patients satisfied certain inclusion and exclusion criteria to identify the site of origin of the headaches or facial pains as coming from the nasal cavities or paranasal sinuses. The majority of these patients (12 patients) were determined to have a septal spur causing the facial pain or headache. Other identified causes included retention cysts (3 patients), mucosal contact points (2 patients), and a dehiscent infraorbital nerve (1 patient). Fifteen of these 18 patients (83%) were significantly improved or cured of their facial pain or headache after medical or surgical therapy. The 3 patients who had either a minimal improvement or no improvement in their facial pains or headaches included 1 patient with an area of mucosal contact between the middle turbinate and the bulla ethmoidalis and 2 patients with septal spurs. In summary, medical or surgical therapy can be beneficial in the treatment of patients with headaches or facial pains of rhinologic origin.