Invasive aspergillosis of the paranasal sinuses represents a life-threatening opportunistic infection that predominantly affects immunocompromised patients. Despite advances in medical therapy, it remains a significant cause of morbidity and mortality, particularly when orbital involvement occurs. We present a detailed case analysis and comprehensive literature review of invasive sino-orbital aspergillosis, focusing on diagnostic approaches, treatment modalities, and outcome measures. A 62- year-old female with poorly controlled diabetes mellitus presented with right maxillary pain and swelling, complicated by sixth and seventh cranial nerve involvement. Through systematic diagnostic evaluation including radiological imaging, surgical intervention, and histopathological analysis, invasive sino-orbital aspergillosis was confirmed. The patient underwent successful treatment with a combination of intravenous Liposomal Amphotericin B, oral Posaconazole, and surgical debridement via Functional Endoscopic Sinus Surgery (FESS). Following aggressive medical and surgical intervention, the patient achieved complete resolution of infection with no evidence of recurrence during the follow-up period. This case emphasizes the importance of early diagnosis and aggressive treatment in managing invasive sinoorbital aspergillosis.