The objective of the study is to assess the role of diode laser coupled with topical mitomycin C (MMC) in the management of synechia after endoscopic sinus surgery. Twenty-five patients with recurrent sinusitis due to synechia between the middle turbinate and lateral nasal wall after endoscopic sinus surgery were included in this study. Diode laser was used to divide the synechia and MMC was applied topically in the area of the middle meatus for 5 min. Patients were followed for 6 months to assess symptoms improvement, recurrence of synechia and CT scan changes. Most of our patients reported improvement of their symptoms, recurrent synechia occurred in 15% of the patients with significant improvement of the CT scan findings. In conclusion, the diode laser with topical MMC is an outpatient procedure which is simple, safe and effective in managing postoperative nasal synechia.