Sinonasal malignant tumors are rare, and have a variety of histopathologies. Multicenter investigation on specific histopathology is paucity. Multimodality treatment with surgery and postoperative radiation therapy is the standard paradigm. The effect of chemotherapy is limited in the management of sinonasal malignancies. Overall survival for sinonasal malignancies remains poor. This paper reviews the progress of diagnosis and treatment in sinonasal malignant tumors in the past decade, including endoscopic endonasal approaches, radiation therapy, chemotherapy as well as targeted therapy. Recommendations on evaluation, treatment strategies, and surveillance are presented.