Many intranasal sinus surgical procedures can be undertaken using the endoscope which provides the surgeon with a clear and well illuminated field of vision, and the ability to inspect recesses with angled distal lenses. Functional Endoscopic Sinus Surgery (FESS) distinguishes the Messerklinger technique, which aims at restoring the natural mucociliary clearance mechanism, drainage and aeration of the sinuses by a minimally invasive anterior-to-posterior technique, from more conventional and radical posterior-to-anterior endoscopic sinus surgery. Hopkins improved the endoscope by replacing lenses with solid rods and fibreoptic illumination, and aided by improved techniques in computer assisted tomography, this has allowed more precise preoperative diagnosis. Meticulous postoperative management, may be the key to the success of endoscopic sinus surgery. Very encouraging results have been reported by many authors. With adequate training and cadaver dissection, endoscopic procedures should not be associated with a higher incidence of complications than ethmoidal surgery by other routes.