Epistaxis is one of the most frequent ENT emergencies, with complex etiologies ranging from local trauma to systemic conditions. This retrospective study analyzed 1,173 patients who presented with epistaxis at a tertiary ENT center over 5 years. Of these, 260 required admissions. The most common triggering factors were hypertension, anticoagulant/antiaggregant therapy, and postoperative complications. A significant portion (38.46%) of cases were idiopathic. Recurrent bleeding was often associated with high blood pressure and male gender, particularly in the 61–70-year age group. Hereditary hemorrhagic telangiectasia was diagnosed in 11 patients, all requiring repeated interventions. Most anterior nasal bleedings had a good response to conservative measures. Posterior or severe cases of epistaxis may require surgical interventions such as cauterization or argon plasma coagulation. The purpose of this paper is to highlight the importance of individualized management, taking into account the location, etiology, and severity. Proper control of cardiovascular comorbidities and careful postoperative monitoring are essential to reducing recurrence and complications associated with epistaxis.