Revision sinus surgery for inflammatory disease has been revolutionized by endoscopic sinus surgery. Clinical trials have shown statistically significant positive outcome data for patient symptoms and quality of life, as well as improvements in objective findings on postoperative nasal endoscopy and computed tomography imaging for patients undergoing revision sinus surgery. The keys to successful revision surgery are adjunctive medical management, aggressive postoperative debridement, mucosal preservation, and removal of osteitic bone. Both the physician and patient should also understand the underlying disease process and comorbid factors so that anticipated postoperative outcomes can be met with realistic expectations.