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Primary atrophic rhinitis seems to have a high prevalence in the arid regions bordering the great deserts of Saudi-Arabia. Fibre-optic endoscopy was performed on 42 patients treated surgically. Fibre-optic endoscopy demonstrated the presence of crusts in the nasal cavities and their subsequent reduction following surgery. It also demonstrated ulceration of the cartilaginous nasal septum in some cases and this may explain the pathogenesis of septal perforation noted in a high number of our patients. Fibre-optic nasendoscopy was also helpful in demonstrating the reappearance of free mucus in the nasal cavity and helped to determine the optimal time for reversing Young’s procedure. Fibre-optic nasendoscopy is a reliable tool for verifying the results of surgery and comparing the efficacy of various treatment modalities.