OBJECTIVE: This prospective randomized trial was designed to compare intranasal endoscopic sphenopalatine artery ligation (ESAL) with conventional nasal packing in the treatment of recurrent epistaxis. METHODS: 47 patients were enrolled in the study following failure of Vaseline nasal packs. 21 patients who informed consent were then managed with ESAL. 26 patients who were not informed consent were then managed with Vaseline nasal packs .Patient demographics, mental and foodintake state, treatment characteristics, number of hospitalization days, saturation of blood oxygen, healing rate, and complications were recorded prospectively. RESULTS: There was a significant reduction in length of hospitalization, saturation of blood oxygen, healing rate, and complications of the patients undergoing ESAL compared with the conventional nasal packings. ESAL was also 90.5% effective in controlling the bleeding and had minimal sequelae or complications. . CONCLUSION: ESAL for treating recurrent epistaxis has proved to be effective (90.5% in our experience) and safe, determining an important reduction in hospital stay and avoiding the morbility of posterior packing.