Background: One of the most prevalent emergent otorhinolaryngological diseases is idiopathic recurrent epistaxis. The present study was conducted to compare microwave ablation and bipolar electrocautery in patients with idiopathic epistaxis. Materials & Methods: 74 patients with idiopathic recurrent epistaxis of both genderswere divided into 2 groups. Each group had 37 patients. Group I underwent microwave ablation and group II underwent bipolar electrocautery. Parameters such as site of bleeding, duration of bleeding, time to achieve successful hemostasis (minutes), VAS on day 1 and day 2 and recurrent bleedingafter 3 days, 1 and 12 weeks, and 6 months were recorded. Results: Group I had 20 males and 17 females and group II had 19 males and 18 females. Bleeding site was middle and posterior nasal septum seen in 10 in group I and 7 in group II, middle meatus region in 7 in group I and 9 in group II, inferior meatus region 9 in group I and 8 in group II, olfactory cleft 6 in group I and 4in group II, Kiesselbach’s area seen in 3 in group I and 4 in group II, and others in 2 in group I and 5 in group II. Time to achieve successful hemostasis was 2.3 minutes in group I and 4.1 minutes in group II. Recurrent bleeding was seen in 5 in group I and 9 patients in group II. The difference was significant (P< 0.05). Pain on VAS on day 1 was 3.4 in group I and 5.7 in group II and on day 2 was 1.2 in group I and 2.8 in group II. The difference was significant (P< 0.05). Conclusion: A good course of treatment for people with idiopathic recurrent epistaxis is microwave ablation.