Epistaxis is a common clinical condition that can be challenging. Anterior epistaxis is managed by compression, cauterization or diathermy. Merocel and Rapid Rhino nasal packs are often successfully used. Refractory posterior epistaxis should be handled by otorhinolaryngologists. If conservative strategies such as combined anterior and posterior nasal packing fail the patient should be referred to surgical intervention. The evidence for early endoscopic ligation and/or diathermy of the sphenopalatine or etmoidal anterior arteries is significant, and the patients experience less co-morbidity.