Empty nose syndrome (ENS) is a clinical entity lacking consensual meaning, illustrating a rare nose surgery complication, particularly of nasal conchae surgery, which results in the destruction of the normal nasal tissue. In severe forms it may become debilitating; the inability in identification and appreciation of this syndrome turns detrimental to the patient. Physiopathology remains controversial, which probably implies disorders caused by excessive nasal permeability, affecting neurosensory receptors as well as the humidification functions and conditioning of inhaled air. Neuropsychological involvement is being suspected. Symptomatology is both variable and changeable, the most evident sign outlining paradoxical nasal obstruction. The diagnosis is based on a series of symptoms that need to be collected precisely, the objective examination that highlights the permeability of nasal fossae. The management is problematic; there are implemented a complete range of simple hygiene and humidification techniques of the nasal cavity and, for more severe cases, surgery is provided, regardless of technique, the surgery targeting partial filling of the nasal airways. Prevention is the most essential strategy along with basic conservative surgical techniques.