Background: Caudal septal deviation is a major cause of nasal obstruction. This problem greatly inhibits normal nasal breathing by narrowing of the nostril and external nasal valve area. It also represents a clear aesthetic problem due to the asymmetry of the nostrils Objectives: To evaluate the clinical outcomes of septoplasty using cartilaginous batten graft in cases with caudal septal deviation regarding the relief of nasal obstruction and aesthetic results. Materials and methods: This prospective single armed study was conducted on twenty patients suffering nasal septal caudal deviation. Septoplasty was performed using a caudal septal batten graft with different technique in each type of caudal septal deviation. We used the validated nasal obstruction septoplasty effectiveness score and visual analogue scale for self-reported nasal obstruction symptoms. Results: The procedure resulted in significant improvements in nasal obstruction. Total NOSE score was significantly improved (decreased) at 3 months and 6 months postoperatively compared to the preoperatively and at 6 months compared to 3 months postoperatively. Congestion, obstruction, breathing, sleep and exercise all were significantly improved (decreased) at 3 months and 6 months postoperatively compared to preoperatively. Regarding basal photography, 11 patients (55%) showed grade I basal photography and 9 patients (45%) showed grade II basal photography. Conclusion: Septoplasty using a cartilaginous batten graft is an effective surgical technique for the management of caudal septal deviation. The technique showed significant improvements of nasal obstruction. The majority of patients achieved satisfactory aesthetic outcomes based on basal view photography with minimal reported complications.