Abstract. This article describes a new method of repairing nasoseptal perforations. The surgical procedure involves rotating a composite transposition flap of mucosa and cartilage anchored at the posterior margin of the perforation. The focus of the repair is to preserve vascularity to the flap and thereby enhance the survival of the cartilage and mucosa. This method appears to be most suitable for repairing small to medium-size perforations. Early success has been promising and warrants a trial by others.