Epistaxis is a common occurrence. The estimated lifetime incidence of epistaxis is approximately 60% and it ranges in severity from a minor nuisance to a life-threatening hemorrhage. Evaluation of recurrent or severe cases includes a search for underlying causes, such as bleeding disorders and neoplasia. Many techniques, materials, and procedures treat nasal bleeding effectively and sometimes more than one treatment must be used. Otolaryngologists must be prepared to deal with severe or refractory bleeding through the use of medications, packing materials, and radiologic or surgical interventions. This article reviews nasal vascular anatomy, common causes of epistaxis, and treatments, including biomaterials and minimally invasive surgical techniques.