In the last decade, the medical community has recognized allergic fungal sinusitis as an unique clinical entity strongly associated with nasal polyps. We will review the differential diagnosis, clinical features, diagnosis, treatment, and prognosis. Appropriate management requires distinguishing allergic fungal sinusitis from other forms of chronic fungal and bacterial sinusitis. Surgical treatment initially results in dramatic improvement, and oral steroids help maintain postoperative success. However, recurrent disease eventually prevails, leaving a glaring need for improved medical treatment.