Osteomas are slow-growing neoplasms of the paranasal sinuses. The previously used management of symptomatic osteomas has consisted of open excision utilizing one of several approaches. Endoscopic sinus surgery offers a convenient, safe and effective alternative to open procedures and can be safely performed in well-selected cases of ethmoid osteoma. The reduced morbidity, length of stay and superior cosmetic result are distinct advantages of this technique.