Background: The management of the posterior epistaxis is very challenging for any otorhinologist. Hot water irrigation (HWI) is a simple and non-invasive technique for the management of posterior epistaxis.
Objective:  To evaluate the efficacy of HWI in the management of posterior epistaxis including the advantages, complications, and factors affecting its success.
Methods: Forty-five patients with posterior epistaxis were included in this research. This is a prospective observational study.
Results: Using HWI, we achieved hemostasis in 39 patients (86.7%), two of them (4.4%) had complications in the form of minimal nasal adhesions. The mean hospital stay was 1.13 days (±0.344). The HWI failed in six patients (13.3%), we controlled epistaxis by anterior nasal packing (ANP) in four patients of them, and the remaining two patients by the posterior nasal pack.
Conclusions: HWI is a safe, efficient, and cost-effective treatment method for posterior epistaxis. This method has the additional benefits of less patient discomfort, less morbidity, less need for surgical intervention, and fewer days of hospitalization.