Objective To investigate the effect of endoscopic sinus surgery combined with other adjunctive therapy on irradiation-induced rhinosinusitis in patients with nasopharyngeal carcinoma (NPC). Methods 37 NPC patients with irradiation-induced sinusitis hospitalized from September 2005 to September 2008 were enrolled in the study. All patients were treated with endoscopic surgery combined with other adjunctive therapy and followed up for 12 to 36 months. The surgery was performed 10 months to 8 years after the irradiation therapy. Results 15 cases (40.5%) were completely cured, 20cases (54.1%) were improved and 2 cases were ineffective. The total effective rate (including the cured and improved cases) was 94.6%. No recurrence was observed. Conclusion Endoscopic sinus surgery is an effective method in the treatment of irradiationinduced rhinosinusitis in patients with nasopharyngeal carcinoma. The key points to enhance the curative effect include the reservation of the useful mucosa and appropriate postoperative therapy.