Background The claim that septoplasty in children should not be done was raised in the early last century. Pediatric septoplasty is highly controversial. Some surgeons are concerned that early surgical intervention before age 17 can adversely affect the normal growth of the nose and face. On the contrary, there is evidence of significant dental, palatal, and facial abnormalities following traumatic damage to the septal cartilage. Therefore, surgical correction of the deviated nasal septum may be performed regardless of the patient’s age. The recommendation of early surgery is based on the explanation that the earlier the correction of septal deviation, the better the outcome of developing normal breath and acceptable facial growth. This study evaluates the nasal and facial bony growth after endoscopic septoplasty for patients below the age of 17 years. Methods This retrospective study reviewed 39 patients who underwent endoscopic septoplasty. The involved patients’ age at surgery was below 17 years old. Postoperative evaluation was done for all patients subjectively using the visual analog scale (VAS) and objectively by endoscopic nose examination. The nasal and facial bony growth were evaluated using lateral cephalometry, which was carried out for each patient when they reached the age of 17. Results Thirty-nine patients underwent endoscopic septoplasty. The median visual analog scale for nose block and headache significantly declined after the procedure significant differences were observed between patients and controls regarding the following parameters: palatal length, anterior skull base, mid-face protrusion, and mid-face length. Conclusion Early endoscopic septoplasty below the age of 17 is a safe procedure and does not compromise the nasal or facial growth when indicated for patients with severe persistent nose block and poor quality of life.