Objectives: This study aims to analyse the management outcomes of total rhinectomy (TR) for nasal squamous cell carcinomas (SCCs) involving the vestibule, and to identify prognostic factors for disease recurrence. Design: A retrospective single centre study was conducted between September 2003 and February 2021 including all patients who underwent a TR for a SCC involving the nasal vestibule. Results: 23 patients were included in the study. Tumours originated from the septum (n=12), vestibule (n=8) or skin (n=3). Six TR (26.1%) were salvage procedures, after primary radiotherapy or nose-preserving rhinectomy. Seven patients had a concurrent neck dissection and 17 patients (73.9%) received adjuvant treatment (14 patients had radiotherapy and 3 had chemoradiotherapy). After a median follow-up of 32 months, six patients (26.1%) presented with tumour recurrence. Three patients (13%) had nodal-only recurrence. The estimated 5-year overall survival, disease-free survival and disease-specific survival was 67.5%, 66.3% and 80.7% respectively. Positive excision margins were a predictive factor for tumour recurrence after TR (p=0.0401). Conclusions: For nasal vestibule SCCs not amenable to limited surgical resection, TR along with adjuvant radiotherapy provide good oncological outcomes and should be considered the main treatment option.