BACKGROUND: Eosinophilia in the nasal secretion and mucosal tissues is the characteristic finding of allergic rhinitis. We compared the effects of nasal budesonide dipropionate and oral terfenadine on the symptom score and nasal secretion eosinophils in perennial allergic rhinitics. MATERIALS AND METHOD: Study subjects consisted of 81 patients with perennial allergic rhinitis and nasal eosinophilia. Fifty-seven patients were treated with nasal budesonide and 24 patients were treated with oral terfenadine for two weeks respectively. Nasal secretion eosinophils were measured as the percentage of total leukocytes under microscope. Symptom scores for sneezing, rhinorrhea, obstruction and itching were graded from 0 (no symptom) to 3 (severe symptom). RESULTS: In budesonide treatment group, symptom score reduction (total symptom score before treatment-total symptom score after treatment) was 5.1, while it was 2.3 in the terfenadine treatment group, which revealed a statistically significant difference (p<0.01). Reduction of eosinophils was 50% in the budesonide treatment group and 28% in terfenadine treatment group (p=0.045). There was statistically significant correlation between total symptom score and % eosinophils (r= 0.668 , p<0.01 ) CONCLUSION: Although both the nasal budesonide and oral terfenadine substantially reduced the proportion of eosinophils in the nasal secretion as well as symptoms in allergic rhinitics with eosinophilia, budesonide was superior to terfendine. Nasal eosinophils correlated with reduction of allergic symptoms in a statisticaly significant manner.