Surgical extirpation is the treatment of choice for nasal dermoids in the pediatric population. Approaches include vertical-dorsal rhinotomy, lateral rhinotomy, transverse rhinotomy, and external rhinoplasty. While short-term results suggest that the last approach is cosmetically most acceptable, the required wide undermining of the nasal tip and dorsum may affect subsequent nasal growth. To assess long-term results, we reviewed our experience with 8 cases encountered over the past 10 years. Modifications of the technique to minimize midline dorsal depression are described.