A variety of hamartomatous lesions have been described in the sinonasal tract. These include respiratory epithelial adenomatoid hamartoma (REAH), seromucinous hamartoma (SH), and nasal chondromesenchymal hamartoma (NCMH). REAH and SH, demonstrate significant morphologic overlap with each other and with reactive conditions, while also being described to develop in association with other distinct tumors entities. NCMH affects a specific patient population with a specific molecular driver. The hamartomatous/neoplastic nature of REAH and SH are a topic of debate. There are emerging sinonasal hamartomatous entities that appear related to REAH and SH.