Olfactory neuroblastoma is an uncommon malignant tumor originating in the olfactory epithelium in the roof of the nose. It usually produces nasal obstruction and secondary sinus disease and is often mistaken by the physician for a nasal polyp. Olfactory neuroblastoma has been observed to cause death by distant metastasis or by invasion through the cribriform plate and secondary meningitis in most instances, and is generally associated with a low cure rate. During the past eight years, we have treated three patients with olfactory neuroblastoma by a combination of extensive local surgery using the lateral rhinotomy approach with ethmoidectomy and medial partial maxillectomy, combined with either preoperative or postoperative irradiation therapy. From a review of the literature we have tried to draw meaningful conclusions regarding treatment.