BACKGROUND: When the insertion of endotracheal tube (ETTs) though the nostril, the tube may be encountered some resistance. Forcing ETTs into the nasal cavity develope mucosal and soft tissue injuries and subsequent epistaxis during passage of the tube even when vasoconstictor and/or lubricant tube are employed. Therefore, We determined whether nasopharyngeal airway (NPA) insertion reduces the incidence of epistaxis and increase the ease of the tube advancement in the nasal cavity during nasotracheal intubation. METHODS: Two hundred adult patients who schesuled for elective surgery were divided into two groups, control (n=100), and NPA (n=100). The NPA insertion group received an armored tube after nasoparyngeal airway inserts, while control group received a plain armored tube. All patients in both groups was inserts ETTs by conventional nasotracheal insertion techniques. RESULT: The NPA insertion group had a significantly low incidence of epistaxis (11%) than control group (34%) (p<0.05). But, provided not easier passage during nasotracheal intubation than control group. CONCLUSION: We conclude that nasophryngeal airway reduces the incidence of epistaxis during nasotracheal intubation, but not to increase easy passage of the tube advancement.