Nasal septal deviation (NSD) is one of the most common abnormalities impacting the maxillofacial development of children. Herein, we investigated the impact of orthopedic rapid maxillary expansion (RME) on the nasomaxillary complex and NSD in pediatric patients. The study sample consisted of a total of 40 patients divided into two groups. The experimental group included 26 patients (13 females and 13 males) with skeletal maxillary transversal constriction and NSD greater than 1 mm, while the control group comprised 14 patients (6 females and 8 males) with skeletal maxillary transversal constriction but no NSD. All the patients were treated for approximately 15 days with the tooth-tissue born RME device. The activation procedure was to turn the transversal Hyrax screw a quarter turn, twice a day. After that, the device was left in place for a period of five months to facilitate passive retention. Radiographic analysis was performed on posteroanterior (PA) cephalometric radiographs taken at pre-expansion (T1) and post-expansion (T2). The data were evaluated using the Mann-Whitney U and Wilcoxon Sign tests. The experimental group showed a statistically significant decrease (p < 0.05) in the distance from the axis of symmetry to middle of nasal septum (SNM-mid) and to inferior part of the nasal septum (SNI-mid) measurements, indicating a reduction in NSD. Additionally, both experimental and control groups showed a statistically significant increase (p < 0.05) in maxillofacial measurements, including the distance between the nose length (X-SNM and SNM-SNAC), width of the nasal cavity (Pir L-R), basal maxillary width (Mx L-R), vestibular cuspid of upper first molars (CVM + L-R) and lower first molars (CVM-L-R). Based on the study findings, RME was considered effective in achieving craniofacial improvement in pediatric patients with NSD, which positively impacted their healthy growth and development. The improvement in the nasomaxillary complex was similar between genders.