To describe our technique in the treatment of significant caudal septal deviation; to evaluate the effectiveness of our technique of caudal septoplasty in the treatment of caudal septal deviations. Retrospective review of cases taken from a database of more than 2000 patients who underwent rhinoplasty performed by 1 surgeon in a private facial plastic surgery practice. Medical charts were reviewed to determine the rate of preoperative nasal obstruction in 59 (95%) of 62 patients as well as nasal obstruction postoperatively 11 (17%) of 62 (P < .001). Photographs were reviewed to determine the severity of caudal deviation and the postoperative result. By photographic evaluation, we found that all but 3 patients had significant improvement in their postoperative appearance. Twenty-six patients had no evidence of residual asymmetry. The rate of revision was 5 (8%) of 62 patients. The caudal septoplasty technique is effective, relatively easy to perform, and shows long-term reliability in correcting caudal septal deviation. In properly selected patients, the technique is effective in improving cosmesis and nasal airflow.