The purpose of this study is to present the authors' experience with nasal valve obstruction and their management scheme. Between July 1, 1988 and June 30, 1991, 27 patients were seen for nasal valve obstruction. There were 17 males and 10 females, with a median age of 39.2 years. The internal valve alone was involved in 14 patients, the external valve was involved in 2 patients, both valves were involved in 11 patients, and significant septal deviation was seen in 15 patients. Nasal valve obstruction resulted from previous surgery in 13 patients, from trauma in 8 patients, and from a "narrow nose" in 4 patients. Twenty-four patients were treated successfully, while 3 patients, seen early in the series, failed to improve. All patients were followed for a minimum of 1 year. Surgery in the nasal valve is done through an open approach and involves a systematic approach to all the structures surrounding the nasal valve. Surgical repositioning and cartilage grafting are used to reconstruct the nasal valve.