This article provides a review of contemporary techniques in nasal septal surgery. Relevant anatomy and physiology of the nose and nasal septum are discussed. The essentials of a complete diagnostic evaluation are outlined. The evolution of surgical approaches to the correction of a deviated septum, including classic submucosal resection, traditional septoplasty, and open techniques, is covered. Complications of septoplasty are reviewed, with an emphasis on prevention and treatment. The recently popularized endoscopic septoplasty, a significant advance in septal surgery, is addressed elsewhere in this issue.