This chapter discusses nasal valve reconstruction, where nasal obstruction is a common symptom of diverse etiologies. Classically, the nasal airway was simplistically considered to be two tunnels separated by a common partition, the septum. The internal nasal valve is the site of greatest structural narrowing within the nasal passageway and consists of the convergence of the upper lateral cartilage with the dorsal septum. Symptoms suggestive of sinonasal inflammation or the presence of a mass lesion warrant nasal endoscopy and may require imaging. The base view reveals the patency of the external nasal valve and may show caudal septal pathology, pinching of the nasal tip, or other structural abnormalities. A rim incision is made along the stenotic nostril and a precise subcutaneous pocket is created along the caudal aspect of the ala, an area that is usually devoid of cartilaginous support. Fixed or dynamic narrowing in the region of the internal nasal valve is a common cause of symptomatic nasal obstruction and a frequent target of surgical correction.