Objective To investigate the surgical treatment of fibrous dysplasia of paranasal sinuses involving skull base or orbit under nasal endoscope. Methods Clinical date of 13 patients treated with endoscopic surgery for fibrous dysplasia of paranasal sinuses involving skull base or orbit were analyzed retrospectively, and a comprehensive evaluation was conducted combining with the surgical and postoperative treatments as well as the treatment effect. Results None of the patients exhibited severe complications. The affected skull base or orbital lesions were completely resected in all the cases, and neither ocular dysfunction nor cerebrospinal fluid rhinorrhea was observed. Follow-up period ranged from 6 to 48 months, and all patients had no recurrence. Conclusion For patients with fibrous dysplasia of paranasal sinuses involving skull base or orbit, nasal endoscopic surgery combined with navigation and plasma technology can completely remove the diseased tissue to achieve the effect of functional reconstruction.