Intranasal dermoplasty and estrogen therapy have been shown to be the most effective means of managing epistaxis in patients with hereditary hemorrhagic telangiectasia. In a series of 80 patients studied, the most effective treatment was by intranasal dermoplasty; of 22 patients so treated, 14 had improvement for more than six months after surgery and six had improvement for one to six months. Regrafting for recurrent epistaxis was successful in four of five patients (improvement for more than six months). Estrogen was administered for systemic effect to 16 patients and produced improvement of more than six months' duration in eight and of one to six months' duration in three. Other forms of management were less effective for the prolonged control of epistaxis.