This report outlines the effectiveness of the transnasal endoscopic approach for the treatment of congenital choanal atresia. Fourteen patients with age between 5 days and 15 years were treated using this approach by means of 0 and 30 degrees 4 or 2.7 mm telescopes: three cases were bilateral while 11 were unilateral. The time of stenting ranged from 3 to 6 days (mean 4 days) in the three newborn patients and between 1 and 2 weeks (mean 1 week) in the other nine patients. In the last two cases, stenting was not carried out. The overall follow-up period ranged from 2 to 64 months (mean 31 months). Only one restenosis was observed in this series 2 months after surgery. This restenosis was successfully treated by endoscopic revision. The authors believe that a correct repositioning of mucosal flaps after the resection of the atretic plate is of paramount importance in avoiding restenosis of the neochoana and in reducing the time and/or the use of stenting.