Objective The EuroQol 5‐Dimension (EQ‐5D) is a general health survey that is quick to administer, widely used, and directly convertible to health utility values (HUV). We aim to describe the five‐year EQ‐5D outcomes among patients who undergo surgical treatment for chronic rhinosinusitis (CRS). Study Design Prospective observational cohort study. Methods Patients with CRS completed the EQ‐5D questionnaire preoperatively and annually for five years following endoscopic sinus surgery. Paired t‐tests and McNemar's tests were used to compare preoperative and postoperative scores. Mixed‐effects modeling was used for multivariate analysis. Results Among 1296 patients enrolled in our study, 812 (74.7%) completed the postoperative survey at one year and 336 (38.9%) completed it at five years. There was a significant and sustained reduction of patients reporting pain/discomfort (74.9% vs. 58.0%, p < 0.001) and anxiety/depression (49.6% vs. 38.1%, p = 0.01) out to five years. Frequency of problems reported in the usual activity domain decreased at one year and was sustained through year four (30.6% vs 19.7%, p = 0.003). After multivariable modeling, female gender ( p = 0.02), prior sinus surgery ( p = 0.01), tobacco use ( p = 0.038), headaches ( p = 0.013), allergies ( p = 0.001), diabetes ( p = 0.022), hypertension ( p = 0.036), higher preoperative SNOT‐22 score ( p < 0.001), and a lower preoperative Lund‐Mackay score ( p < 0.001) were associated with significantly worse EQ‐5D HUV over time. Similarly, a worse EQ‐5D Visual Analog Scale (VAS) over time was associated with allergies ( p = 0.03), diabetes ( p < 0.001), hypertension ( p = 0.04), higher preoperative SNOT‐22 score ( p < 0.001), and prior sinus surgery ( p < 0.001). Conclusion Patients with chronic rhinosinusitis experience significant sustained improvements in health‐related quality of life up to five years after ESS as measured by the EQ‐5D instrument. Level of Evidence Level 2 Laryngoscope , 134:2592–2601, 2024