Background: Septal deviation is a prevalent cause of nasal obstruction, affecting up to eighty percent of the general population. Aim: To compare the influence of septal quilting sutures against nasal packing versus internal nasal splint in septoplasty as regard headache, pain following the operation, sleep disturbance, bleeding, hematoma, epiphora, synechia and crustation. Patients and methods: This randomized prospective comparative clinical trial has been conducted on 60 cases with deviated nasal septum causing persistent complaint of nasal obstruction. Patients were recruited from Otorhinolaryngology outpatient clinic, Mansoura University Hospital from November 2021 to November 2022. Results: A statistically significant variance has been observed between the three groups with regard to the median VAS score of pain, bleeding, headache, epiphora and sleep disturbances at 2^nd Post-Operative Day ⁽POD). A statistically significant variance has been observed between the three groups regarding the median VAS score of Pain, bleeding and Sleep disturbances at 7^th POD. A statistically insignificant variance has been observed between the three groups regarding the median VAS score of headaches and epiphora at 7^th POD. Conclusion: Quilting sutures at the end of septal surgery are preferred because the cases experienced minimal unpleasant symptoms compared to nasal packing or internal nasal splints, and also it is not time consuming to us and is available all the time. On the contrary, nasal packing (Merocel) and silicone internal nasal splints may be unavailable sometimes in addition they cause many unpleasant symptoms to the patients.