Otolaryngology has been uniquely shaped by warfare due to the high rates of facial, airway and auditory injuries sustained. This historical review explores how successive wars catalysed the evolution of ear, nose and throat(ENT) surgery and directly influenced modern civilian practice. Early military campaigns exposed the lethality of acute airway obstruction from trauma, infection and inhalational injury, prompting refinement of emergency tracheostomy and laryngeal surgery. During the Napoleonic and Crimean wars, facial gunshot wounds led to early reconstructive techniques and nasal flap principles that underpin modern rhinoplasty. World War I represented a watershed moment: the establishment of maxillofacial units, led by pioneers such as Harold Gillies, transformed the management of complex facial and nasal injuries, while systematic surgical treatment of chronic suppurative otitis media and mastoiditis reduced mortality among soldiers living in trench conditions. Blast exposure during this period also laid the foundations for modern understanding of acoustic trauma and noise-induced hearing loss. World War II further advanced ENT surgery through the introduction of antibiotics, improved anaesthesia, blood transfusion, and microsurgical principles, allowing safer head and neck reconstruction and airway management. The use of chemical warfare agents refined management of laryngotracheal injury, while wartime rehabilitation programs accelerated the development of facial prosthetics, voice rehabilitation following laryngectomy, and early auditory amplification. Subsequent conflicts refined damage-control airway strategies, triage systems, and multidisciplinary trauma care. By tracing these wartime innovations and their transition into civilian care, this historical literature review highlights how adversity shaped many of the techniques and philosophies that underpin modern otolaryngology.