A B S T R A C T Background: In the last decades, incidence of allergic rhinitis (AR) showed steadily increase in developed and developing countries; with profound effects on patient life and overall health care system. In intractable AR, endoscopic neurectomy of posterior nasal nerve had been introduced as a curative alternative. However, its efficacy and safety not adequately addressed.    Objective: The current study aimed to present our clinical experience with endoscopic posterior nasal neurectomy [safety and efficacy] and to address its effect on the patient quality of life. Methodology: A sixty-three patients with AR were included. Clinical symptoms of AR had been assessed before and at 3, 6 and 12 months after surgery using a numerical score. In addition, patients had been asked to fill a 28-items rhinoconjunctivitis quality of life (RQoL) questionnaire.    Results: There was progressive and significant improvement of clinical symptoms and improvement of the RQoL scores after surgery when compared to preoperative values. All scores reduced significantly at 3 months with subsequent reduction at 6 months which become stable to the end of the first year, except quality of life which showed another significant reduction at the end of the first year when compared to values at the 6^th postoperative month. No major complications had been recorded, and the overall successful control on nasal symptoms had been recorded for 68.3%, 81.0%, 88.9% and 79.4% for sneezing, itching, rhinorrhea and nasal obstruction, respectively. Conclusion: Endoscopic posterior nasal neurectomy is an effective and safe surgical technique for treatment of AR resistant to medical therapy.