Objective: modification of septal incision in severely deviated septum to make dissection more easily and with minimal complications. Method: our study was done on 97 males and 65 females, who did septoplasty with severe unilateral or bilateral deviations in 2 tertiary hospitals, at 2 different cities; by the same surgeon. Data analysis was conducted from March 1, 2011, till November 30, 2014. These patients were divided into 2 groups: group A included 122 patients and group B included 40 patients. Patients of group A underwent modified hemitransfixation caudal approach to the cartilaginous and bony septum while patients of group B underwent with classic Killian incision for septoplasty. Results: we found that the new modification had fewer complications as regard septal perforation, synechiae ….and with minimal operative time than standard Killian incision. Conclusion: This approach for septoplasty is safe, easy and with complications less than the standard killian incision.