Allergic fungal sinusitis is a newly characterized disease entity that has commanded a great deal of interest over the past 2 decades. As more information is gathered about its underlying etiology, clinical presentation, and response to therapy, the treatment of allergic fungal sinusitis is becoming more refined. Most current treatment protocols for allergic fungal sinusitis are based upon a combined surgical and medical approach. This article addresses pertinent surgical aspects as related to the management of allergic fungal sinusitis.