Objective To investigate the effect and related influencing factors of highly selective pterygotomy in the treatment of allergic rhinitis(AR).Methods Clinical data of 39 patients who underwent nasal endoscopic highly selective pterygotomy due to moderate to severe persistent AR from January 2018 to March 2023 were collected.Efficacy was evaluated according to quality of life and subjective symptoms before and 6 months and 12 months after surgery,and the patients were divided into the effective group and the ineffective group,and then the factors affecting the long-term surgical efficacy were analyzed.Results The scores of nasal conjunctivitis Quality of Life questionnaire(RQLQ)and visual analogue scale of subjective symptoms(VAS)at 6 and 12 months after operation were lower than those before operation(P<0.05).The number of patients with invalid combination and nasal polyp and asthma was higher in the effective group(P<0.05).Logistic regression equation analysis showed that nasal polyp and asthma were both risk factors affecting the long-term surgical outcome of AR patients.Conclusion Pterygotomy can be a satisfactory treatment for AR patients,but from the perspective of long-term efficacy,nasal polyps and asthma are the risk factors affecting the surgical efficacy.