Objective：To analyze the clinical efficacy of low temperature plasma radiofrequency ablation of Krouse T2 and T3 nasal inverted papilloma（NIP）under nasal endoscope. Methods：Clinical data of 141 cases with Krouse T2 and T3 NIP treated with endoscopic surgery at the Department of Otolaryngology Head and Neck Surgery，the Affiliated Nanjing Hospital of Nanjing Medical University（Nanjing First Hospital）from October 2012 to October 2022，were retrospectively analyzed，and the tumor was resected and treated with or wthout low temperature plasma radiofrequency ablation during the operation. They were divided into observation group using low temperature plasma radiofrequency ablation and control group without low temperature plasma radiofrequency ablation. The operative time，intraoperative blood loss，average length of hospital stay，postoperative visual analogue scale（VAS）score of pain， postoperative complications and postoperative recurrence rate were compared between the two groups. Results：The average operation time of NIP patients with T2+T3 and T3 stage in the observation group was less than that of the corresponding control group，but the difference was not statistically significant（P ＞ 0.05）；the average operation time of NIP patients with T2 stage in the observation group was less than that of the corresponding control group，and the difference was statistically significant（P ＜ 0.05）. The average intraoperative blood loss，the average length of hospitalization，and postoperative pain VAS scores of patients with T2+T3，T2 and T3 stage in the observation group were lower than those in the corresponding control group，and the difference was statistically significant （P ＜ 0.05）. There was no statistical significance in the postoperative complications of patients with T2+T3，T2 and T3 stage in the observation group compared with the corresponding control group（P ＞ 0.05）. The postoperative recurrence rate of patients with T2+T3 and T3 stage in the observation group was lower than that of the control group，with statistical significance（P ＜ 0.05），while the postoperative recurrence rate of patients with T2 stage in the observation group was lower than that of the control group，with no statistical significance（P ＞ 0.05）. Conclusion：Low temperature plasma radiofrequency ablation under nasal endoscope can treat Krouse T2 and T3 stage NIP and its base under a clear surgical field of view. It has the advantages of less intraoperative blood loss， shorter length of hospitalization，less pain and lower recurrence rate，compared with routine operation. And it has satisfactory clinical efficacy，which is worthy of popularization and application.