Purpose of Review: The aim of this analysis is to provide a synopsis of the surgical methods utilized to treat nasal valve collapse resulting in airway obstruction, and to evaluate and contrast lateral crural strut grafts (LCSG) and lateral crural tensioning (LCT). Recent Findings: Lateral crural strut grafting is a major technique used to treat external nasal valve collapse. However, in recent years, lateral crural tensioning combined with articulated alar rim grafts (AARG) has become popular. A study comparing LCT-AARG to LCSG demonstrated a greater reduction in total nasal airway resistance, as measured by rhinomanometry. Summary: While LCSG creates a rigid structure, it may require a fair amount of cartilage and has the potential to crowd the airway. In contrast, LCT-AARG can achieve the same improvement in airway however consumes less cartilage, is less likely to crowd the airway, is preferential in narrow noses, and has the additional aesthetic benefits associated with rim grafting.