Objective: To evaluate the clinical efficacy of four-line tension-relaxing correction in the treatment of nasal septum deviation. Methods: A retrospective case series study was conducted. Clinical data from 56 patients with nasal septum deviation who underwent four-line tension-relaxing septoplasty at Changsha Hospital of Traditional Chinese Medicine between October 2021 and May 2023 were collected. Visual Analogue Scale (VAS) scores and nasal resistance values were compared preoperatively and at 1 year postoperatively. Results: At 1 year postoperatively, the VAS score on the deviated side (1.73 ± 1.04) was significantly lower than the preoperative value (6.68 ± 1.05) (t=24.971, P < 0.05). Nasal resistance values on the deviated side during inspiration (0.85 ± 0.17) Pa/(cm3·s) and expiration (1.17 ± 0.47) Pa/(cm3·s) were also significantly improved compared to preoperative values [inspiration: (3.93 ± 0.75) Pa/(cm3·s), expiration: (3.01 ± 0.63) Pa/(cm3·s)] (t=29.817, 17.276, respectively, both P < 0.05). No statistically significant differences were observed in VAS scores or nasal resistance values on the patent side between pre- and postoperative assessments (P > 0.05). Conclusion: The four-line tension-relaxing septoplasty effectively corrects nasal septum deviation and significantly alleviates nasal obstruction by thoroughly releasing deviational tension. It demonstrates stable long-term outcomes and is suitable for clinical application.T