AIMS AND OBJECTIVES:TO study the frequency of occurrence of anatomical variations in nose and paranasal sinus region among patients after medical management with persisting symptoms of chronic rhinosinusitis.To know the demographic distribution of anatomical variations of nose and paranasal sinus region. MATERIALS AND METHODS:In this study ,CT scan of paranasal sinus will be carried out on 100 patients clinically diagnosed of chronic rhinosinusitis.Duration of this study is for 2years .Plain CT paranasal sinuses perfomed on GE revolution ACT machine (50 slice). RESULTS:Deviated nasal septum was the most common variation in 62% followed by sphenoid sinus septations in 49%.Other variations found were middle concha bullosa in 43% patients.Paradoxical middle turbinate in 14%,horizontal uncinate process in 43%,over pneumatised ethmoidal bulla in 35%,frontal sinus septations in 31%,superior concha bullosa in 20%,prominent agger nasi cells in 26%,haller cells in 11%,onodi cells in 6%,maxillary sinus septae in 12% and pneumatisation of uncinate process in 5% patients. CONCLUSION:The presence of anatomical variants does not indicate a predisposition to sinus pathology but these variations may predispose patients to increase risk of intraoperative complications.The radiologist must pay close attention to anatomical variants in the postoperative evaluation and provide a road map to surgeon and help avoid possible complications and improve success of management strategies.