This chapter discusses epistaxis, which arises from a perturbation in the normal hemostatic mechanisms of the nose. Up to 60 percent of people will have an episode of epistaxis over their lifetime with approximately 6 percent requiring medical attention. Certainly external trauma with or without nasal bone fracture can cause intranasal lacerations, where habitual nose rubbing or picking can lead to superficial mucosal interruption which may progress to ulceration. Topical nasal sprays can also cause mucosal irritation leading to epistaxis. Any anatomic abnormality associated with exposure of one area of the mucosa to excess or turbulent airflow may, over time, result in excessive dryness, crusting, and bleeding. Alcohol, even in small amounts, can significantly prolong bleeding times and lead to epistaxis, where the external carotid artery (ECA) and internal carotid artery (ICA) both contribute to the blood supply of the nose.