Intranasal drug delivery is a rapidly growing field that offers the potential for enhanced treatment of local and systemic disease. Novel preclinical screening tools such as in vitro assays and 3-dimensional imaging are currently being used to improve drug design and delivery. In addition, new evidence has emerged underlining the importance of surgical marsupialization of the sinuses to allow for improved topical delivery. Although multiple barriers to administration and absorption exist, implantable therapeutics using new classes of drug-eluting polymers allow for prolonged, site-specific drug delivery and hold great promise in overcoming these obstacles.