Background: Nasal septum deviation (NSD) is a common problem in otolaryngology clinics and constitutes one of the healthy adults' most common anatomical variations. NSD may result in a deviation of either the bony or cartilaginous septum or both, leading to a disruption of the nose's physiological function and a distortion of its shape. Aim: In this review, we will look into the etiology, classification, management, and complications of nasal septum deviation. Methodology: Medline, Google Scholar, EMBASE, and PubMed database searches were performed for articles about the most significant recent developments in classification, etiology, and management updates of the deviated nasal septum, published in English around the world. Conclusion: NDS's have a critical role in functional and effective nasal breathing. Diagnostic modalities as rhinomanometry, acoustic rhinometry, as well as nasal spectral sound analysis can come in handy in identifying DNS. Though common, there are concerns that the benefits of nasal septal surgery might be mainly cosmetic. However, there is a debate on the effectiveness of adult septoplasty for nasal obstruction.