Aspergillosis of the paranasal sinuses may occur as a chronic disease in an otherwise healthy person. This infection is usually confined to a single paranasal sinus, the maxillary antrum, though it can involve the orbit and may initiate with findings of proptosis and decreased vision. The disease is characterized by a wide range of initial symptoms, and should be considered as a possible diagnosis in sinusitis refractory to antibiotics and antral lavage. Conservative surgical debridement of involved tissues and drainage of sinus, with or without adjunctive antifungal therapy, results in cure of this disease.