Background The aim of this study was to determine the presence and location of telomerase activities and the possible influence of elevated human telomerase reverse transcriptase (hTERT) mRNA levels on the outcome after surgical treatment in nasal polyposis. Methods Telomerase activity in nasal polyps of 21 patients was quantified by measuring the hTERT mRNA contents with one-step real-time polymerase chain reaction. Inferior turbinates of 12 patients served as controls. Immunohistochemistry with specific antibodies was performed against hTERT. The number of hTERT marked cells was determined in 15 randomly selected fields. All patients were followed up after surgery for 60 months. Results Elevated hTERT mRNA expression and number of hTERT+ cells was detected in nasal polyps in comparison with inferior turbinates (p < 0.001). hTERT+ cells were detected in the basal layer of the epithelia, the endothelia, and in some seromucous glands. During follow-up, it was discovered that tissue samples of five patients with recurrent polyposis did not have higher amounts of hTERT when compared with patients without relapse. Conclusion Telomerase activity is elevated in nasal polyps. Elevated hTERT expression does not predict the recurrence of nasal polyposis after surgical treatment.