The objective of this chapter is to focus on the surgical aspects of fungal diseases of nose and paranasal sinuses. Fungal sinusitis is a common disease in the Indian subcontinent, and elsewhere especially in the developing world. The disease encompasses a heterogeneous spectrum. Careful interpretation of clinical and radiological findings is paramount as management of various spectra is different and some drugs, such as steroids may be treatment of choice in one form and highly counterproductive in other. The disease has been classified largely on the basis of immune status of the host and the immune response to the fungus. Some overlap exists between various subtypes. Broadly, fungal sinusitis is classified as noninvasive and invasive. Mode of diagnosis of various fungal disease subtypes is different. Mycetoma and AFRS can be readily diagnosed clinic radiologically and tissue diagnosis is generally confirmed only after therapeutic excisions.