Background: A variety of methods can be used to treat inferior turbinate hypertrophy that has not improved with the medical treatment including turbinectomy, laser and turbinoplasty as well as radiofrequency ablation. Objectives: This study aimed to compare the results and outcome of radiofrequency ablation with that of endoscopic turbinoplasty in cases of inferior turbinate hypertrophy that are resistant to the medical treatment. Patients and methods: Thirty-four patients having refractory inferior turbinate hypertrophy have been divided randomly into two groups. Group (A) included patients who underwent endoscopic inferior turbinoplasty, while group (B) contained patients who underwent radiofrequency ablation. Results: Three-months postoperatively, within each group, there was a statistically significant decrease in the inferior turbinate hypertrophy grading, but with no statistically significant difference between the two groups. As well, there was a statistically significant improvement of the nasal symptoms VAS in each group. However, there was a statistically significant more improvement of the postoperative nasal obstruction VAS in the radiofrequency group than in the endoscopic turbinoplasty group. Whilst, there was a statistically significant more improvement of the postoperative sneezing VAS in the endoscopic turbinoplasty group than in the radiofrequency group. Conclusion: Both techniques are effective for inferior turbinate reduction. Radiofrequency ablation is a minimally invasive technique and more effective than endoscopic turbinoplasty in relieving nasal obstruction.