Obstructive sleep apnea (OSA) is a disease with significant physiologic and quality of life consequences, impacting a large portion of our population. As Otolaryngologists, we possess a unique understanding of upper airway anatomy and physiology central to this disease. We have the ability to provide both surgical and non-surgical treatment for OSA. As we further our understanding of the pathophysiology of OSA, disease phenotypes, and develop new diagnostic and therapeutic options, we are able to provide care directed at the individual patient’s disease. The one size fits all approach to OSA has transitioned to a personalized, patient centric model. The personalized care model allows for the assessment of factors leading to the individual patient's OSA, the review of treatment options and patient goals of therapy, and recommendations for treatment. This may employ surgery to optimize tolerance and effectiveness of non-surgical therapy, a combination of surgery and conservative treatment, or multi-site surgery. The goals of the session are to utilize brief lecture and case-based discussions to highlight; A) The role of nasal surgery in positive airway pressure (PAP) optimization. Various approaches to the relief of nasal obstruction allow for improved PAP tolerance and compliance by lowering the required PAP pressure and allowing for a comfortable mask interface. B) Options for combined surgical and non-surgical treatment. Frequently, the outcomes of single site surgery can be optimized by employing additional non-surgical options. This may involve the utilization of positional therapy or a mandibular advancement device in addition to surgery. C) Options for multi-level surgery. OSA is frequently related to multiple sites of upper airway collapse. Advanced physical exam and diagnostic techniques are useful in identifying these sites of obstruction and choosing appropriate surgical interventions. This may include the combined use of surgery for the palate, base of tongue, facial skeleton, hypopharynx, and/or neurostimulation.