This retrospective study evaluates the incidence and spectrum of infectious complications in 100 consecutive adult nasal septoplasty patients. A total of 12 patients (mean age 40 years; age range 24-55 years) suffered from postoperative infection, and 3/12 had received prophylactic antibiotics. Patients presented with abscess formation (n = 7), submucosal swelling and flush (n = 4) and haematoma and high fever (n = 1). None of the patients had life-threatening complications, such as meningitis, endocarditis or septic/toxic shock. After surgical drainage, antibiotic treatment was given orally or intravenously. The mean hospitalization time was 3.6 days. To assess the clinical outcome, 8/12 patients were re-examined about 1.8 years after the operation. They all had an improved rhinological status. Septoplasty had been successful in relieving nasal obstruction in seven (88%) patients. Staphylococcus aureus was isolated from the nasal mucosa in three (38%) patients, which is in line with previous findings in healthy nasal septoplasty patients. The use of antimicrobial prophylaxis in septal surgery will be discussed.