About 5% of all epistaxis cases regarded as posterior category which is one of the challenges of management in the emergency units because the majority of patients are elderly with several co morbidities. Several management methods attempted from anterior and posterior packing to endoscopic control but still no standard method designs for its management. To discuss the causes and different methods in the management of posterior epistaxis in our hospitals of Basra, Iraq. In this study, 56 patients with posterior epistaxis were admitted to ENT departments of two hospitals at Basra, Iraq and dealt with several techniques of management according to the cause of bleeding. Fifty six patients aged between 3 and 78 years, of them there were 37 males and 19 females admitted to ENT department and managed with different ways according to the response of treatment which was ranging from anterior nasal packing only to lastly with endoscopic management under general anesthesia. Posterior epistaxis is not common entity account for about 5% of all epistaxis cases, hypertension remains an important issue in the management and nasal packing is still the main way to control bleeding.