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Objective: To compare the frequency of post-operative adhesions after endoscopic sinus surgery with and without intranasal silastic splint. Study Design: Quasi experimental study. Place and Duration of Study: Research was conducted at department of ENT, Combined Military Hospital Muzaffarabad, from Sep 2016 to Mar 2017. Methodology: This study involved 62 patients of both genders aged between 15-60 years undergoing endoscopic sinus surgery who were randomly allocated into two treatment groups. Patients in groups-A received silastic splint in addition to anterior nasal packing while those in group-B received anterior nasal packing alone. Outcome variable was frequency of post-operative adhesions which was noted and compared between the groups. Results: The mean age and SD of the patients was 33.58 ± 11.11 years. The mean duration of symptoms was 11.81 ± 3.20 months. Both the study groups were comparable in terms of mean age (p=0.910), mean duration of symptoms (p=0.876) and age (p=0.866), gender (p=1.000) and duration of symptoms (p=1.000) groups. Postoperative adhesions were observed in 5 (8.1%) cases and all of them belonged to study group-B. The frequency of post-operative adhesion formation was significantly higher in patients receiving anterior nasal packing alone (16.1% vs. 0.0%; p=0.020) as compared to those receiving silastic splint in addition to anterior nasal packing. Similar difference was observed across various age, gender and duration of symptoms groups. Conclusion: The use of silastic splint was associated with significant reduction of post-operative adhesions in patients undergoing endoscopic sinus surgery regardless of patient's age, gender and duration of symptoms. [ABSTRACT FROM AUTHOR]