Septoplasty is a common surgical procedure done in ENT practice for the correction of deviated nasal septum (DNS). Deviated nasal septum causes chronic nasal obstruction which is one of the commonest ENT complains. In our clinical practices eustachian tube (ET) dysfunction may occur due to deviated nasal septum. ET dysfunction lead to changes in middle ear pressure and ventilation. Eustachian tube is a communication between middle ear and nasopharyngeal cavity, and its primary physiological functions are the ventilation of middle ear and equalizes environmental pressure of the external environment with that of middle ear. In addition to protect the middle ear from nasopharyngeal secretions and drainage middle ear secretions into nasopharynx.Few studies are available with varied results. Some studies have reported improvement middle ear pressure after septoplasty. On the other hand, some reported no change in middle ear pressure after septoplasty. In Saudi Arabia, no studies have been done to examine the association between septoplasty and improvement in middle ear pressure. Thus, it is important to monitor the effect of septoplasty on change middle ear pressure and ventilation.This is a prospective analytical study done in the ENT outpatients department of King Abdul-Aziz University Hospital in Jeddah. thirty patients suffering from deviated nasal septum requiring septoplasty by closed technique were admitted to the study. Their age ranged between 18 to 50 years. All patients included in this study underwent full clinical history and examination of the nose, nasopharyngeal and ear. Middle ear pressure assessment was done by tympanometry AZ26 preoperatively, postoperatively after one week and one month postoperatively. Patients suffering from other diseases causing nasal obstruction or disruption Eustachian tube functions or pathology in ears were excluded from this study. The results obtained from our study showed no significant difference in middle ear pressure values between the same side and contralateral of deviated nasal septum before septoplasty and no significant changes in middle ear pressure values on both side of the nasal after septoplasty procedure.