Introduction Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign, yet locally aggressive vascular tumour affecting adolescent males. Endoscopic resection has generally become the preferred approach over open techniques due improved clinical outcomes. Aims To review current evidence regarding outcomes following endoscopic resection of JNA. Methods A narrative review of PubMed literature (2005 – 2025) was conducted. Results Endoscopic surgery is the technique of choice for JNA classified as Radkowski stage IA to IIB. More advanced tumours with extension into the infratemporal fossa or beyond (stage IIC and higher) generally require open or combined approaches for broader surgical exposure.1 Preoperative embolisation of external carotid artery branches remains standard practice, shown to approximately halve mean intraoperative blood loss. In stage IA to IIB disease, mean blood loss averages 544ml endoscopically versus 1579ml with open surgery.2 However, with intracranial involvement (stage III disease), open surgery results in less bleeding – 1500ml compared with 2998ml. Patients undergoing endoscopic resection generally experience shorter hospital stays, averaging a 3-day admission versus 4 days in open approaches. Additionally, endoscopic resection is associated with a recurrence rate of 0-7%. This is a notable improvement over historical rates of 30–50% associated with open approaches, attributed to incomplete resection with residual tumour in poorly visualised areas such as the pterygopalatine fossa or basisphenoid region.1 Conclusion Endoscopic resection of JNA offers lower blood loss and shorter hospitalisation in appropriately selected patients. Open resection offers lower morbidity in more extensive disease. Careful staging and preoperative planning are essential to optimise surgical success and minimise recurrence. References 1. Lee JT et al. Oper Tech Otolaryngol Head Neck Surg. 2010;21(2):156–65. 2. Boghani Z et al. Laryngoscope. 2013;123(4):859–69.