OBJECTIVES: The aim of this study was to reveal the efficacy of different nasal mucosal flap techniques in the repair of nasal septal perforation. PATIENTS AND METHODS: Between April 2006 and May 2009 21 patients (12 males, 9 females; mean age 36.6+/-12.7 years; range 17 to 60 years) with the complaints of nasal obstruction, bleeding, crusting, whistling during inspiration, and pain and in whom septum perforation was detected were operated on and they were included in this study. The patients were followed-up for an average of 16.9 months (3 to 35 months). Cross-stealing technique was performed on 11 patients while advancement flap was performed on three patients and rotation flap was performed on seven patients. Patients were followed-up for at least three months before the evaluation of the postoperative results. RESULTS: Complete closure was observed in 16 out of 21 patients (76.2%) and partial closure in one patient (4.8%). In four patients (19%) perforation was not closed and its size remained unchanged. CONCLUSION: In the literature, many different surgical techniques have been described for the repair of nasal septal perforation. The main aim of the repair is not only the closure of perforation but also the restoration of normal function and physiology in the nose. In order to achieve this, the most physiologically and anatomically suitable method is the closure of nasal septal perforation with three layers composed of two mucoperichondrial flaps and one interpositional graft. Although cross-stealing technique may be an anatomically and physiologically feasible option for the closure of small-middle sized perforation located anteriorly, the highest success rates are obtained with advancement and rotation flaps when the location and size of perforation are considered.