Many cosmetic surgeons consider rhinoplasty to be the most complex surgical and artistically challenging of all aesthetic surgery today. It is the most common facial procedure performed for women and the second most common for men. The art and science of cosmetic rhinoplasty begins with the initial examination. The surgeon must visualize and predict like Leonardo Da Vinci, be a sculptor like Michelangelo, and be an analyzer like Einstein. This article describes the components and complexities of the initial examination in cosmetic rhinoplasty.