Epistaxis is one of the most frequently managed otorhinolaryngological emergencies. This prospective study over a 4-month period involved 38 adult patients presenting with epistaxis who underwent endoscopic bipolar diathermy under local anaesthesia. Thirty-four (89%) of the 38 adults were successfully treated and 28 (74%) of the patients did not require admission. Based on a simple cost-benefit analysis of savings made by avoiding admission, successful immediate treatment of these 28 patients led to a potential saving of at least pound 6804.00. We conclude endoscopic bipolar diathermy under local anaesthesia is an effective, safe and cost-efficient modality of treatment in the management of adult epistaxis.