Objective To investigate the clinical efficacy of endoscopic pterygoid nerve combined with anterior ethmoidal nerve transection in treatment of allergic rhinitis with nasal polyps.Method A clinical practice study was conducted on 108 patients with allergic rhinitis complicated with nasal polyps. After enrollment, they were randomly divided into two groups, 54 cases were included in the control group and treated with conventional endoscopic sinus surgery, while 54 cases were included in the observation group and treated with conventional endoscopic sinus surgery combined with pterygoid nerve and ethmoidal nerve transection. The nasal pain visual analogue scale (VAS), rhinoconjunctivitis quality of life questionnaire (RQLQ), asthma quality of life questionnaire (AQLQ), total effective rate, and complication rate of the two groups were compared before treatment and 1 week, 2 weeks, 3 weeks, 3 months, 6 months, and 1 year after treatment.Result Compared with the control group, the total effective rate of treatment was 98.15% in the observation group, which was higher than 85.19% in the control group, the difference was statistically significant (P < 0.05). Before treatment, there were no significant differences in nasal resistance (NR), mucociliary transport rate (MTR), mucociliary transport time (MTT), and Lund-Kennedy scores between the two groups, the differences were no statistically significant (P > 0.05). After treatment, MTR in two groups increased compared with before treatment, and the observation group was higher than the control group, the difference was statistically significant (P < 0.05); NR, MTT, and Lund-Kennedy scores in two groups decreased, and the observation group was lower than the control group, the differences were statistically significant (P < 0.05). Before treatment, there were no significant differences in nasal pain VAS, RQLQ, and AQLQ between the two groups, the differences were no statistically significant (P > 0.05). After treatment, at 1 week, 2 weeks, 3 weeks, and 3 months, 6 months, and 1 year, the observation group had lower nasal pain VAS compared to the control group, while the observation group had lower RQLQ and higher AQLQ compared to the control group, the differences were statistically significant (P < 0.05). The incidence of complications in the observation group was lower than the control group, the difference was statistically significant (P < 0.05).Conclusion The clinical efficacy of endoscopic pterygoid nerve combined with ethmoidal nerve transection for the treatment of allergic rhinitis complicated with nasal polyps is significant. It can not only effectively alleviate nasal pain in patients, but also improve their quality of life and reduce postoperative complications, which has clinical application value.