The evolution of endoscopic sinus surgery has been marked by a changing landscape of sinus surgeries from the main hospital operating room to the outpatient ambulatory surgical center toward office-based procedures. A rapid return to work, no general anesthesia, and decreased procedural costs are among the reasons why patients and surgeons may choose office-based procedures. Office-based procedures continue to increase in breadth and scope, and satisfy both patients and providers when performed following established guidelines and with the same high standards as are expected in any operative setting.