Nasal obstruction in a child is a common manifestation of a variety of disorders seen in both general practice and general otolaryngology. As both symptom and sign, it may be labeled as nasal congestion, blocked nose, nose discomfort, “sinus,” snotty nose, stuffy nose, or snuffly nose. The anatomy of the child differs from the adult; the child’s nose goes through rapid changes before being deemed fully-grown. The measurement of nasal airflow begins with the simple misting of the shiny polished surface of a mirror, or the fine movement of wispy cotton wool placed at the nostrils, to the passage of catheters from the anterior nares to the oropharynx, when excluding choanal atresia. Symptoms of the nasal disease are described in detail in this chapter. The major signs of nasal disease in a child with blocked nose include mucosal or cutaneous swelling, excessive or unusual nasal secretions, and mouth breathing. Investigations that are commonly performed to investigate the child with nasal obstruction include imaging, histological tests, and microbiological tests. Pyriform aperture stenosis, choanal atresia, mid-nasal stenosis, tumors of the pediatric nose, foreign bodies, septal deformity, rhinosinusitis, adenoidal hypertrophy and allergic rhinitis are the specific pediatric conditions which are discussed throughout this chapter. Surgical management with innovative techniques using endoscopes, powered instrumentation, hemostatic devices, and self-absorbable fillers or packing, has allowed safer surgery with reduced morbidity figures.