Objectives: To compare the effects of hypertonic and normal saline nasal spray on mucociliary clearance and nasal airway patency.Methods: Double-blind trial with subjects acting as their own controls. Saccharin clearance times and acoustic rhinometry measurements were obtained in healthy subjects before and after instillation of either 3.0 percent hypertonic or 0.9 percent normal saline solution. On a different day, subjects returned and the same procedure was performed with the other solution. Setting: Tertiary care academic medical center. Participants: Twenty-two healthy volunteers without any significant sinonasal disease participated in the study. Exclusion criteria included upper respiratory tract infection 3 weeks prior to the study, history of significant allergies, rhinitis, smoking, or current use of nasal medication.Results: Hypertonic saline and normal saline both improved saccharine clearance times (P < 0.0001 for hypertonic) and (P = 0.002 for normal saline). Hypertonic saline improved saccharine clearance times more than normal saline (39.6% vs 24.1%), (P = 0.007). Neither hypertonic nor normal saline significantly affected nasal airway patency.Conclusion: Both hypertonic and normal saline nasal spray significantly improved saccharine clearance times without affecting nasal airway patency. Hypertonic saline affected saccharine clearance times to a greater degree than normal saline.