Objectives: The aim of this study was to compare the efficacy and side effects of non-dissolvable packing for the management of epistaxis. Design: Prospective, observational cohort study. Setting: A large university teaching hospital with an emergency department. Participants: Consecutive adults requiring non-dissolvable packing for the management of acute epistaxis between March 2020 and March 2021. Main outcome measures: Likert-scale questions based on the SNOT-22 questionnaire to assess side effects associated with non-dissolvable packing; and pain scores on insertion, whilst in-situ and on removal. Results: A total of 80 adults requiring non-dissolvable packing were included. 47% of patients presented following a first episode of epistaxis and 52% required inpatient management. 70% of patients had a Rapid Rhino pack inserted. Rapid Rhino had an increased incidence of patient-perceived embarrassment (30%, n=17) compared to patients packed with Merocel (8%, n=2). Patients packed with Rapid Rhino also had an increased severity of embarrassment (0.46 ±0.11) compared to patients packed with Merocel (0.13 ±0.09). Merocel packs had a higher mean pain score on removal (6.09 ±0.73) compared to Rapid Rhino (4.05 ±0.43). No significant association was noted between rebleed rates and pack type or rebleed rates and inpatient versus outpatient management. Conclusion: Non-dissolvable nasal packs, Rapid Rhino and Merocel, have similar efficacy in controlling epistaxis. Rapid Rhino packs are more embarrassing for patients in comparison to Merocel packs but are less painful to remove. Patients were successfully managed in the outpatient setting without an increased complication rate.