OBJECTIVE: To determine the compliance with and tolerance of nasal saline irrigation in children. STUDY DESIGN: Phone survey. SETTING: Tertiary pediatric hospital. METHODS: Children diagnosed with nasal congestion and rhinorrhea from sinusitis, chronic rhinitis or allergic rhinitis were identified. Children who were prescribed a therapeutic course of nasal saline, who were instructed how to administer the treatment and who were available for follow up were included. Parents were contacted by phone and asked to complete a questionnaire regarding their child's experience with nasal saline irrigation. RESULTS: 61 Children met inclusion criteria. 73% of parents initially thought that nasal saline irrigation would be helpful, but only 28% thought that their children would tolerate the treatment. 93% of children made an attempt to use nasal saline irrigation and 86% were able to tolerate the treatment. 84% of parents whose children attempted nasal saline irrigation noted an improvement in their child's nasal symptoms. 77% of children that attempted nasal saline irrigation continue to use this treatment for symptom relief. 93% reported an improvement in their child's overall health that they attributed to this treatment. CONCLUSIONS: Perhaps the biggest barrier to routine recommendation of nasal saline irrigation in children is the assumption by both parents and physicians that children will not tolerate it. However, this study demonstrates that the majority of children, regardless of age, were judged by their parents to tolerate nasal saline irrigation.