The ability to identify surgical sinus disease using diagnostic nasal endoscopy and coronal CT scanning of the paranasal sinuses is studied prospectively. Fifty consecutive patients with symptoms of chronic sinusitis lacking surgical indications by traditional work-up comprise the patient population. Sixty percent had endoscopic or CT indications for surgery. There was a 90% correlation between endoscopy and CT examination with the combined work-up being more accurate than either modality alone. Functional endoscopic sinus surgery was performed in 18 cases. There were no major complications. Approximately 89% of the postoperative group report significant improvement, with 55.6% reporting total relief of symptoms. A complete endoscopic sinus work-up can often identify surgically correctable sinusitis despite normal routine rhinoscopic and plain-film examination. It is therefore, warranted in those patients with a suggestive history.