OBJECTIVESTo explore the role of endoscopic surgery for palliative intent in patients with advanced sinonasal and anterior skull base neoplasms.STUDY DESIGNRetrospective, multi‐institutional case series.SETTINGTertiary academic center.SUBJECTS AND METHODSThe medical records of six patients with advanced sinonasal and skull base neoplasms undergoing endoscopic surgery for palliative purposes were reviewed for patient demographics, treatment course, and postoperative outcome measures.RESULTSThe histology in this series included metastatic sinonasal mucosal melanoma in three patients, and high‐grade sarcoma, chordoma, and pituitary carcinoma each in one patient. The predominant symptoms in all patients related to sinonasal mass effect and local extension of disease. Symptomatic improvement was achieved in five of the six patients despite the poor overall outcome from the underlying lesion. There were no perioperative complications in this series.CONCLUSIONEndoscopic surgery may allow for palliation in advanced sinonasal and skull base neoplasms. The indications for this procedure are individualized on the basis of disease demographics and overall prognosis.