BACKGROUND Vidian neurectomy has in the past been advocated for the treatment of vasomotor rhinitis. With the recent better understanding of nasal and sinus anatomy, the surgical technique and outcomes of this procedure have been reassessed in this preliminary report. METHODS A total of nine patients with symptoms of vasomotor rhinitis underwent 14 endoscopic vidian neurectomies between 1998 and 2001. All patients had negative screening for allergies on their serum or on skin-prick tests. The surgical technique for endoscopic vidian neurectomy is presented. The outcomes for the patients were retrospectively assessed with patients asked to score their pre- and postoperative symptoms rating these symptoms on a scale of 1-10 after a mean follow-up of 25 months (range, 21-36 months). RESULTS On this retrospective analysis there was a significant improvement in the symptoms of rhinorrhea (p = 0.018) and nasal obstruction (p = 0.011). There was no significant difference between the pre- to postoperative symptoms for postnasal drip or sneezing. The most common minor adverse effect was dry eyes (35.7%) and nasal crusting (28.6%). CONCLUSIONS Endoscopic vidian neurectomy improves the symptoms of nasal obstruction and rhinorrhea in patients with vasomotor rhinitis.