Objectives: To propose a novel scoring system for the prediction of recurrence disease after endoscopic excision in advanced stages of juvenile nasopharyngeal angiofibroma (JNA). Materials and methods: Retrospective case series review of 30 cases of advanced-stage JNA patients encountered within a period of three years (2016–2019). All the patients underwent a complete endoscopic excision which was preceded by embolization. Postoperatively, all the patients were followed up after 4 weeks, 3 months, and 6 months for recurrent disease. A scoring system was devised to reanalyze the risk of recurrent disease in all the patients who were a part of the study. Results: All the patients were male adolescents presenting with typical complaints of JNA like progressive unilateral nasal blockage, spontaneous painless epistaxis, and facial swelling. The patients who were recently diagnosed with JNA belonging to Fisch stages 3a, 3b, and 4 were only chosen for the study. Residual and recurrent cases were excluded. Preoperative contrast-enhanced computer tomography (CT) was done for all the patients. All the patients were preoperatively embolized, and the surgical technique used in all the patients was through a complete endoscopic approach. Conclusion: The endoscopic approach is possible for all stages of JNA. The endoscopic method reduced the postoperative morbidity to a great extent. The risk of recurrence could be predicted using the scoring system which was statistically significant.