A review of 250 patients with malignant disease of the nose and paranasal sinuses treated over a 20 year period is presented. Treatment could be divided broadly into three groups consisting of subradical surgery plus radiotherapy; a drainage procedure plus radiotherapy and radiotherapy alone. Three and 5 year survival rates are presented for each mode of treatment for tumours originating in four anatomical sites. In tumours of the maxillary antrum the 5 year survival was significantly higher in patients who underwent a partial maxillectomy or palatal fenestration before radiotherapy. In the other anatomical sites the survival rates were not significantly different. Although this is an uncontrolled retrospective review, it does add further data to that already published on this uncommon but difficult management problem.