Complaints of nasal obstruction after rhinoplasty and nasal surgery are disheartening for both the patient and the surgeon. When a patient presents with complaints of nasal obstruction after rhinoplasty and nasal surgery, the surgeon must reassess the history of symptoms and physical attributes contributing to nasal airway narrowing. The patient's expectations from surgery must also be discussed. The goal is total management of mucosal and anatomic contributors to nasal obstruction. This article describes various causes of nasal obstruction so as to provide rhinoplasty surgeons with the background needed to enhance their preoperative evaluations and avoid future surgical complications.