The purpose of this study was to evaluate the efficacy of a modified mattress suture technique in septal anterior deviation correction and to compare it with the Hinderer technique. This was a randomized, controlled, single-blind clinical trial. Fifty patients with anterior septal deviation were assigned to one of two surgery treatment groups: in group A, 25 patients underwent anterior septoplasty with modified mattress suture technique; and in group B, 25 patients underwent anterior septoplasty with the Hinderer technique. Subjective (oral respiration, epistaxis, rhinorrhea, and nasal obstruction) and objective (anterior rhinomanometry) parameters were analyzed and compared between groups. Better results in obstructive deflections were achieved with the modified mattress suture technique. Unilateral and total nasal resistances improved during the 6-month follow-up in patients who underwent anterior septoplasty with the modified mattress suture technique, and there was a significant difference in the values when compared with patients who underwent anterior septoplasty with rhinoplasty using the Hinderer technique (p = 0.003). The modified mattress suture technique had better subjective and objective results than rhinoplasty with the Hinderer technique and therefore could be considered as an alternative technique in anterior septal surgery.