PURPOSE: Respiratory epithelial adenomatoid hamartoma (REAH) is an infrequently encountered noncancerous growth. Hamartomas are characterized by excessive pseudoglandular proliferation of the ciliated respiratory epithelium originating from the surface of the respiratory epithelium. METHODS: In this retrospective series, we present three cases of Saudi patients diagnosed with REAH between 2015 and 2023. We summarize patient demographics, clinical presentation, radiological features, histopathological characteristics, treatment modalities, and outcomes to enhance the understanding of REAH, inform clinical management strategies, and provide an updated literature review. RESULTS: Our patient population (male, 2
female, 1) had a mean age of 44 years and exhibited REAH at various locations in the nasal cavity. All three patients were treated surgically, without recurrence during the follow-up period. CONCLUSION: This series contributes to the growing body of evidence that, although rare, REAH may be more common than previously thought, necessitating awareness among clinicians for better patient outcomes.