Recurrent sinusitis is an increasingly important disease in its own right and is an often overlooked underlying trigger for chronic asthma and/or bronchitis. The complications of unresolved recurrent sinusitis may include intracranial conditions with significant clinical implications. Patients failing conventional therapy require more aggressive therapy to avoid the necessity for invasive measures, and extensive patient education may help increase compliance with the regimen. Invasive measures (surgery) for the treatment of recurrent sinusitis carry a serious complication rate of 0.5% in 200,000 cases/ year. For this reason, aggressive medical management of these patients is an essential effort. This article explores recurrent sinusitis and its pathophysiology, and suggests a medical treatment regimen using nasally inhaled corticosteroids together with antimicrobial and supportive therapy.