In tropical environment in Mali the septoplasty is a less common surgical procedure. The lack of specialist in ENT made that often patients with trauma of the nose are not correct support. This situation causes the existence of septal deviation undiagnosed in a timely manner. Aim: To report our experience in the appropriate management of nasal septal deviation in the tropics. Patients and methods: A retrospective study was carried out in 33 patients with symptomatic deviated nasal septum who underwent septoplasty in the ENT Unit of the reference health center in Bamako (Mali), from March 2010 to August 2014. All patients were operated under local anesthesia; a Killian’s incision was used in all patients. Results: Between 2010 and 2014, a total of 33 patients, aged 22-51 years (mean 36 years), 30 (90.90%) male and 3 (9.10%) female, underwent septoplasty for deviated nasal septum. The observed probable causes were: not established 27 cases (81.81%) and traumatic 6 cases (18.19%). The essential symptoms were: nasal obstruction, facial pain, vasomotor rhinorrhea. 30 patients (90.90%) have only benefited a nasal packing and 3 patients (9.10%) had a septal suturing and a nasal packing. The total disappearances of the preoperative symptoms were observed in 90% of cases and increased moderate in 10% of cases. Conclusion: Despite its rarity in our unit, the septoplasty is a procedure that must occupy a significant place in rhinologic surgery of our country considering the results of this study.