First a historical review is given of the development of the concept of wedge resection of the bony nasal pyramid since Joseph, 1907. In a second part the technical details about wedge resection are described for different types of nasal deformities. In a third part long-term results in 100 patients, 18 months after septorhinoplasty are presented. In 61 patients unilateral and in 39 patients bilateral wedge resections were performed as one step of rhinoplasty. The long-term results were good in 93 patients, there was undercorrection in six cases, whereas one patient had an overcorrected nose. These results are better than the long-term results following classic osteotomies alone. Thus the wedge resection, for the indications as defined in this study, is a very useful step in the concept of corrective and aesthetic septorhinoplasty.