Nasal reconstruction has reached a point in its evolution such that its goals no longer include simply filling the defect. The contemporary facial reconstructive surgeon aims for an aesthetic and functional result in the vast majority of cases. Cutaneous nasal defects most often result from oncologic surgery, such as either Mohs excision or square technique, or, less commonly, traumatic or iatrogenic injury. This article discusses the current practices in the repair of nasal defects. Although this article focuses on reconstruction of oncologic defects, the principles discussed can be effectively applied to traumatic defects, as well.