Objective：To explore the therapeutic efficacy and safety of omalizumab in the Chinese AERD patients. Methods：A retrospective analysis was performed on 32 AERD patients who received omazumab in the Department of Otolaryngology, the First Affiliated Hospital of Chongqing Medical University from January 2019 to April 2023. Nasal symptoms VAS score, nasal polyp score (NPS), sinus CT Lund-Mackay score (LMS), University of Pennsylvania Olfactory recognition Test (UPSIT) score, peripheral blood eosinophilic count, exhaled nitric oxide (FeNO), pulmonary function and adverse reactions, quality of life score before and after treatment were compared. Results： After 24 weeks of omazumab treatment, the VAS scores of runny nose and head and facial pain did not improve significantly, but the VAS scores of nasal congestion and anosmia decreased, the UPSIT scores increased significantly (P < 0.05), suggesting the improvement of nasal symptoms. After treatment, NPS, LMS and SNOT-22 scores were significantly decreased (P < 0.05), indicating that sinus inflammation was obviously controlled and quality of life was improved. After treatment, pulmonary ventilation function improved, FeNO decreased and ACT score increased, indicating that lower airway inflammation control and symptoms were significantly improved (P < 0.05). After treatment, the absolute value of peripheral blood eosinophils decreased significantly (P < 0.05). The adverse reaction of 270 injections was 0.3%, indicating good safety. Conclusion：The application of omalizumab for the treatment of AERD was initially observed to have good efficacy, controlling both upper and lower airway inflammation with few adverse reactions.