Spontaneous enophthalmos has been reported to occur after demineralization of the orbital floor from chronic maxillary sinusitis. We report a 24-year-old female who developed spontaneous enophthalmos without demineralization of the orbital floor. A contracture from the maxillary sinus apparently pulled the orbital floor downward. Release of the fibrous tissue through a combined orbital and sinus approach produced satisfactory correction of the enophthalmos without the use of alloplastic implants. This case suggests that fibrotic contraction in the maxillary sinus pulling the floor of the orbit downward can produce spontaneous enophthalmos without boney destruction.