To assess the possibilities and limitations of endoscopic septal spur resection in combination with endoscopic sinus surgery, 40 consecutive patients were prospectively evaluated. All patients suffered from chronic sinusitis and presented with a posterior septal spur. The spur resection was mainly done because of impaction on the middle meatus and was in general performed after the sinus procedure, if technically possible. Although not completely painless, the septal spur resection could be easily performed under local anesthesia. The procedure took on average less than 5 minutes. The immediate postoperative period was always uneventful and no septal perforations were recorded at six weeks. There were no late complications. In conclusion, endoscopic resection of a septal spur can be performed safely in combination with endoscopic sinus surgery and contributes with minimal additional morbidity to the surgical success.