Traditional frontal sinus surgery is associated with a significant trauma. Herein, we have discussed the feasibility, technique, and efficacy of a minimally invasive anterior-to-ethmoidal bulla surgical approach performed under nasal endoscopy to treat isolated frontal sinusitis. Fifteen patients with isolated frontal sinusitis underwent the anterior-to-ethmoidal bulla surgical procedure under general anesthesia. The opening of the frontal sinus was located by frontal mini-trephination in 1 patient. The effects of the operation were evaluated by regular postoperative follow-up. The average postoperative follow-up period was 12.7 months (range 6-24 months). The postoperative symptom of headache was completely resolved in all 15 patients, and 12 patients had good opening of the frontal sinus and complete epithelization was observed by nasal endoscopy. The frontal sinus of 3 patients was not opened, but these patients did not show subjective symptoms. The anterior-to-ethmoidal bulla surgical approach is ideal for isolated frontal sinusitis.