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Conclusion: The modified septoplasty with three tension lines resection is an effective and well-tolerated procedure, which can improve the objective and subjective outcomes, and provide a good approach that is applicable for various septal deviations, especially caudal deviation. Objectives: According to the biomechanics of the septal deviation, a modified septoplasty with three high tension lines resection was redefined. The purpose of this study was to review the surgical technique and objective and subjective outcomes. Methods: A retrospective review was conducted to identify patients undergoing septoplasty between 2005 and 2006 at Beijing Tongren Hospital. The records were reviewed for demographic data, intraoperative technique, surgical indications, objective and subjective outcomes, and postoperative complications. Results: A total of 54 patients were identified. The follow-up period ranged from 6 to 12 months. Indications for septoplasty included nasal obstruction (40.7%) and access (59.3%). The data showed that both the objective and subjective outcomes improved after septoplasty. Complications included transient dental pain/hypesthesia (5.6%), synechiae formation (7.4%), epistaxis (1.9%), septal hematoma (3.7%), asymptomatic septal perforation (0%), and nasal deformity (0%).