To report the long-term follow-up of 25 years of experience in 100 consecutive cases of septal perforation (SP) repair using the technique of the senior author (F.P.). From 1981 to 2006, a total of 100 consecutive patients were surgically treated and followed up for 1 to 10 years. The medical records of 68 of the patients were retrospectively examined. Outcomes were assessed based on comparison of the results of preoperative and last follow-up assessment of SP size and symptoms. The SP repair technique consists of subperichondrial/periosteal dissection, rotation of nasal mucosa for tension-free closure, with no mucosa incision if possible, and a multilayer closure with interposition graft. The most common symptoms were nasal obstruction (72%), crusts (50%), and epistaxis (31%). Previous nasal surgery was the pathogenetic factor in 39 cases (57%). Fifty-two patients (76%) presented with SPs measuring 1.0 to 3.0 cm in diameter. The internal approach was used in 54 cases (79%), and temporal muscle fascia and conchal cartilage were concomitantly used in 45 cases (66%). The great majority of patients (40 [59%]) received more than 5 years of follow-up. The success rate of closure was 97%. Two patients (3%) presented with reperforation measuring less than 1.0 cm in diameter. The senior author's SP repair technique is easily accomplished, provides good visualization, and is low in cost. Also, in our experience, the success rate of closure has been 97%.