We investigated the influence of four nasal decongestants and one preservative on ciliated cells, using cell cultures of human nasal mucosa. These cells were exposed to nasal decongestants in vitro. A fast decrease in ciliary beat frequency was seen during naphazoline and oxymethazoline application which was fully reversible after naphazoline. There was only a minimal decrease in ciliary beat frequency during application of phenylephrine and xylomethazoline decongestants. The preservative benzalkoniumchloride caused an irreversible decrease in ciliary beat frequency which was concentration dependent. We therefore recommend nasal decongestants which contain xylomethazoline or phenylephrine. If the preservative benzalkoniumchloride can not be substituted by newer less harmful substances, it should be added in minimal concentrations.