This study was to follow up and evaluate the results of the transcartilaginous approach to tip rhinoplasty as regards advantages, simplicity, outcome and rate of complications. Study was held on patients with different tip deformities including preoperative, operative and postoperative management. This study showed that the transcartilaginous approach is a simple approach with direct access to the cartilage, allows the alar cartilages to be resected at a predetermined level, preserves the facets and avoids injury to the nasal valves with the least postoperative side effects and short operative time.