Headache is a common clinical symptom in multiple disciplines with many causes and complex pathogenesis. Rhinogenic headache is a headache caused by nasal sinus disease, but some headaches are easily misdiagnosed and treatment is delayed because the nasal symptoms are not obvious. The clinical manifestations of rhinogenic headache are divided into obvious nasal symptoms and inconspicuous nasal symptoms. Obvious nasal symptoms are nasal congestion, pus, loss of smell, and also eye swelling and visual strain; obscure nasal symptoms are mainly headache, and in this case, rhinogenic headache is often misdiagnosed as migraine or tension headache. Nasal endoscopy may reveal dark red nasal mucosa, purulent discharge, turbinate congestion and edema, nasal septal deviation, nasal lychee flesh-like neoplasm, and even nasal tumor. Correct diagnosis of rhinogenic headache and identification of the cause is the key to treatment: ① Sinus CT and sinus endoscopy show mucosal adhesions or tight contacts and abnormalities in the anatomical structures of the nasal cavity and sinuses; ② Sinus CT and sinus endoscopy show polyp-like changes in the middle turbinate, high deviation of the nasal septum, and contact points between the nasal septum and turbinates, for which local anesthetic drugs ( placebo) are placed on The patient’s pain symptoms were temporarily relieved (3-5 min); ③ Patients who were misdiagnosed with migraine or neurogenic headache for a long time, repeated the examination and confirmed the diagnosis of rhinogenic headache, and then used endoscopy to remove the abnormalities of nasal cavity and sinus anatomy through nasal and sinus surgery, and the patient’s headache symptoms were significantly relieved or disappeared; ④ Patients with more serious conditions underwent Oral and pharyngeal examinations are performed in more severe cases, and the patient’s nasal lesions are manifested in the pharyngeal wall, mainly in the form of purulent secretions or dry crusts on the pharyngeal wall; ⑤ Other possible causes of headache are investigated, such as brain or neurological diseases. Endoscopic treatment of rhinogenic headache: If you have the following conditions in your daily life, you should consider rhinogenic headache first: ① chronic headache for a long time; ② headache aggravated by cold or exertion; ③ headache without knowing the exact cause. The diagnosis of rhinogenic headache should be treated promptly. Rhinogenic headache requires nasal endoscopic surgery, which removes the diseased tissue in the nose, relieves the extrusion caused by the abnormal anatomical structure of the nasal cavity and sinuses, removes the abnormal contact points inside the nasal cavity, and eliminates the triggers such as pressure and obstruction in the nose, in order to relieve or cure the headache symptoms. The surgery should be performed to avoid expanding the scope of the surgery as much as possible and to minimize the damage to the normal tissue in the nose.