Objective: To analyze the clinical effect of low temperature plasma resection of Krouse T2 and T3 nasal inverting papilloma under nasal endoscope. Methods: The clinical data of 141 cases of Krouse T2 and T3 nasal inversion papilloma treated by the Department of Otolaryngology head and neck surgery, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital) from October 2012 to October 2022 and underwent endoscopic surgery were retrospectively analyzed, and the tumor was resectosed and treated according to whether low temperature plasma was used during the operation. They were divided into observation group using low temperature plasma and control group without low temperature plasma. The operative time, intraoperative blood loss, average length of stay, preoperative and postoperative pain VAS score, postoperative complications and postoperative recurrence rate were compared between the two groups. Results: The average operation time of T2+T3 and T3 tumor patients 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 T2 tumor patients 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 of T2+T3, T2 and T3 patients in the observation group was lower than that in the corresponding control group, and the difference was statistically significant (P < 0.05). The average length of hospitalization of T2+T3, T2 and T3 patients in the observation group was lower than that in the corresponding control group, and the difference was statistically significant (P < 0.05). Postoperative pain VAS scores of T2+T3, T2 and T3 patients in the observation group were lower than those in the control group, and the difference was statistically significant (P < 0.05). There was no statistical significance in the postoperative complications of T2+T3, T2 and T3 patients in the observation group compared with the corresponding control group (P > 0.05). The postoperative recurrence rate of T2+T3 and T3 stage patients in the observation group was lower than that of the control group, with statistical significance (P < 0.05); the postoperative recurrence rate of T2 stage tumor patients in the observation group was lower than that of the control group, with no statistical significance (P > 0.05). Conclusions: Low temperature plasma radiofrequency ablation under nasal endoscope can treat Krouse T2 and T3 sinus inverted papilloma 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, low recurrence rate, and satisfactory clinical efficacy, which is worthy of popularization and application.