ObjectiveTo investigate the methodology and reliability of endoscopic sphenopalatine artery sliver clipping in management of refractory epistaxis.MethodsTwentytwo patients with severe intractable posterior epistaxis who had undergone various procedures like nasal packing, electroorchemical cautery or others and still exacerbated,were subjected to this study. Performed nasal endoscopy under general or local anesthesia. Then located sphenopalatine foramen and anatomized sphenopalatine artery and its branches after the longitudinal incision of mucoperiosteum which was at the attachment of the posterior part of the middle turbinate. Afterwards, one or two sliver clips were used to occlude sphenopalatine artery and its branches. Finally, reset mucoperiosteal flap and filled it with hemostasis gause and expansive sponge.ResultsTwentytwo patients had been followed up for 6 to 36 months with an average of 23 months. Twenty patients did not suffered from recurrent epistaxis during the period.Only 2 patients suffered from recurrent epistaxis in the sixth month and the ninth month respectively.They did not suffered from epistaxis after electric cautery the anterior ethmoidal artery on the same side.ConclusionsSliverclipping of the sphenopalatine artery,as a purely endonasal procedure is an effective and microinvasive means of achieving longterm control of refractory epistaxis.It has few complication compared with the other forms of arterial ligation.