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Sinus disease is a very common source of morbidity for many children. On average, children average 6-8 upper respiratory tract infections per year. 5-13% of all URIs are complicated by secondary bacterial infection of the paranasal sinuses. Young children are unable to communicate some of the symptoms of sinusitis such as headache, nasal obstruction, and sinus pain/pressure. This may pose a diagnostic challenge to clinicians who must rely on parental reporting of symptoms and physical findings. The purpose of this Grand Rounds is to explore the evidence available investigating pediatric FESS to determine its indications, safety, and long-term efficacy. A focus is kept on the management of chronic rhinosinusitis in the pediatric population.