Objective To explore the effect of autologous costal cartilage in rhinoplasty. Methods A total of 110 patients who underwent rhinoplasty in our hospital from July 2022 to June 2024 were selected as the research subjects, and they were divided into the control group and the experimental group by the random number table method, with 55 patients in each group. The control group was treated with silicone or expanded polytetrafluoroethylene (ePTFE) filling, and the experimental group was treated with autologous costal cartilage filling. The nasal tip protrusion, wound healing time, hospitalization time, nasal shaping effect, complications and satisfaction were compared between the two groups. Results The nasal tip protrusion after surgery in the experimental group was higher than that in the control group (P <0.05). The wound healing time and hospitalization time in the experimental group were shorter than those in the control group (P <0.05). The scores of nasal tip mobility, natural aesthetics, nasal shape three-dimensionality, nasal bridge prominence, nostril diameter and nasal tip fullness in the experimental group were all higher than those in the control group (P <0.05). The incidence of complications in the experimental group (1.82%) was lower than that in the control group (12.73%) (P <0.05). The satisfaction of the experimental group at discharge and 1, 3 and 6 months after surgery was higher than that of the control group (P <0.05). Conclusion The application of autologous costal cartilage filling in rhinoplasty can effectively improve the nasal tip protrusion, enhance the nasal shaping effect, and is beneficial to shorten the wound healing time and hospitalization time. The incidence of postoperative complications is low , and the application effectiveness and safety are high.