Abstract: Objective To explore the treatment of nasal inverted papilloma by simple endoscopic sinus surgery, nasal endoscopy+Ke-Lu surgery and nasal endoscopic transnasal approach. Methods In this study, 80 patients with nasal inverted papilloma underwent endoscopic sinus surgery were selected as the endoscopic surgery group, 80 patients with nasal endoscopy+Ke-Lu surgery were treated as nasal endoscopy+Ke-Lu surgery group, and 80 patients with nasal endoscopic transnasal approach were selected as nasal endoscopic transnasal approach group in our hospital from January, 2011 to December, 2015. The intraoperative blood loss, operation time, hospitalization time, postoperative recurrence and postoperative complications were collected of the three groups. Results The intraoperative blood loss, operation time and hospital stay of nasal endoscopy+Ke-Lu surgery group and nasal endoscopic transnasal approach group were higher than that in endoscopic surgery group (P<0.05). There were no significant difference in the recurrence rate of stage Ⅰ and stage Ⅱ nasal inverted papilloma among endoscopic sinus surgery, nasal endoscopy+Ke-Lu surgery group and nasal endoscopic transnasal approach group (P>0.05). The recurrence rate of stage Ⅲ nasal inverted papilloma in endoscopic sinus surgery group was higher than that of nasal endoscopy+Ke-Lu surgery group and nasal endoscopic transnasal approach group(P<0.05). The recurrence rate of stage Ⅲ nasal inverted papilloma of nasal endoscopy + Ke-Lu surgery group was lower than that of the nasal endoscopic transnasal approach group, but the difference was not statistically significant(P>0.05). The nasal inverted papilloma after surgery of nasal endoscopic surgery group, nasal endoscopy+Ke-Lu surgery group and nasal endoscopic transnasal approach group stage Ⅰ patients were all 0 cases. There were no significant difference in the incidence of postoperative complications of stage Ⅱ and stage Ⅲ patients among the three groups(P>0.05). Conclusion The intraoperative blood loss, operation time and hospital stay of simple endoscopic surgery for stage Ⅰ and Ⅱ patients with nasal inverted papilloma are less, but the postoperative recurrence rate of the treatment of stage Ⅲ nasal inverted papillomais is high. The stage Ⅲ patients with nasal inverted papilloma is suitable for endoscopy+Ke-Lu surgery and nasal endoscopic transnasal approach.