Background, Septoplasty is one of the commonest nasal surgeries performed by otolaryngologist. Silicone is the most common material used for nasal splints. Trans septal suturing technique has been described to approximate the mucosal flaps after septal procedures to reduce the complication rate, however there are few studies proving the efficacy. Objective, This study is to elucidate the efficacy of trans septal suture method in preventing complications, discomfort and pain in comparison with intranasal splinting using silicone plates after septoplasty. Patients and methods, This is a prospective study of 59 adult patients underwent Septoplasty, between August 2013 January 2014 in Rizgary Teaching Hospital Erbil city. Patients were divided into 2 groups, trans septal suture and silicone, 29 and 30 patients respectively. Visual analogue scale was used to evaluate postoperative pain, bleeding, post nasal drip, dysphagia and sleep disturbance for three days. Epiphora and septal hematoma are also evaluated. Septal perforation, crustation, and adhesion were evaluated at 4th postoperative week. Results, The severity of pain and post nasal drip were significantly lower in trans septal suture group than silicone group (P 0.05). The septal hematoma and septal perforation were not seen in the study. No any significant difference found concerning epiphora, crustation and adhesion. Conclusion, we conclude that, suturing can be used safely in septoplasty specially when the septal deformity is not so complicated.