CASE REPORT: A 69-year-old male patient reported nasal obstruction and anosmia since he had undergone polypectomy and septoplasty. Nasal endoscopy revealed a large septal perforation, as well as signs of middle turbinate partial turbinectomy and ethmoidectomy. The patient was diagnosed with empty nose syndrome and maintained on conservative treatment. FINAL COMMENTS: Due to compensatory hypertrophy of the contralateral inferior turbinate deviation, septoplasty is usually accompanied by turbinate surgery. The empty nose syndrome is a rare disorder characterized by iatrogenic paradoxical nasal obstruction despite a broad nasal cavity. This condition is associated with resection of the turbinate and septal perforation. Although well-established diagnostic criteria are currently lacking, conservative treatment typically involves nasal irrigation. The primary surgical options are autologous nasal implants and biomaterials. Optimal surgical planning is important to minimize postoperative complications such as septoplasty and turbinectomy.