Thirteen patients suffering from nasal septal perforation were repaired surgically with posterior based mucoperiosteal flap of the lateral wall of inferior meatus during recent 3 years. Among these cases, 8 had moderate and the others had large septal perforations over 2cm in diameter. 6 cases(75%) showed complete closure in moderate perforations, and 3 case(60%) showed complete closure in large central perforation. But 4 cases(31%)(moderate perforation; 2, large perforation; 2) showed necrosis of flap and reperforations in spite of two stage operations using opposite side mucoperiosteal rotation flap. Therefore, the posterior based mucoperiosteal rotation flap seemed to be of the excellent surgical procedures for correction of the large septal perforation.