Background Cartilage provides the structure of the nose and is an essential consideration in nasal surgery. Autologous costal cartilage is considered the gold standard as it is thought to be cheaper and safer than cadaveric alternatives. However, the time for harvest and the morbidity of the donor site has meant cadaveric cartilage has become increasingly popular. This review seeks to evaluate these two cartilage sources, examining safety, efficacy and cost. Methods A review of cartilage graft options for rhinoplasty and reconstruction was undertaken. Results Numerous case series and studies have compared cartilage options. A recent study looked at 54 studies and included 888 patients, with 741 receiving autologous grafts whilst 153 received cadaveric. There was no statistically significant difference in warping, resorption, contour irregularity, infection and revision surgery. These results are consistent with other single centre studies. The reduction in theatre time through using cadaveric graft and the absence of donor site morbidity, may offset its high expense. Conclusion Current literature suggests that there is no difference in outcomes between autologous and cadaveric cartilage grafts. Whilst higher quality studies are needed, the potential of cadaveric cartilage grafts suggests that they can be safely used and may even have a role to play in reconstruction more generally.