Aerosols generated during endoscopic sinus procedures present a concern to the health and safety of healthcare personnel, especially with the presence of coronavirus disease (COVID-19). The purpose of this study is to describe the design and testing of a nasal cover to restrict aerosolized pathogens. The nasal cover was designed to sit overtop the nose with conformal slits for insertion of endoscopic instrumentation. Polydimethylsiloxane (PDMS) was chosen as the nasal mask material and its composition, thickness, and slit geometry were selected using a Taguchi experimental design and survey with clinical collaborators at Penn State Milton S. Hershey Medical Center. The nasal cover was designed using principles of origami engineering to be manufactured flat and then folded into its operating state. Form and functionality were evaluated by surgeons, fellows, and residents in the aforementioned survey. Aerosol containment was evaluated by measuring smoke, representative of surgical aerosols, with an optical particle counter. A 25:1 composition PDMS with 3 mm thickness and vertical slit geometry was chosen for the nasal cover design. Survey results demonstrated that the origami cover sat well on the nose and did not significantly impact the surgical conditions with single instrumentation. On average, this nasal cover was found to restrict more than 93% of 0.3 μm aerosols, and more than 99% of all aerosols larger than 0.5 μm in size. The use of a patient worn nasal cover has the potential to drastically reduce the risk to hospital personnel during endonasal surgeries by reducing aerosol generation and potential pathogen spread.