Lateral rhinotomy and medial maxillectomy have evolved in the last 25 years as the treatment of choice for most neoplastic lesions involving the lateral nasal wall. Technical refinements have allowed this procedure to be performed with acceptable and minimal morbidity. This approach has had its widest application in the treatment of inverted papilloma, with a concomitant marked reduction in the recurrence rate of this tumor compared with more limited procedures. Its advantages are the excellent exposure provided, the opportunity to extend the approach to adjacent areas of tumor extension (orbit, cranial vault, frontal and contralateral ethmoid sinus), and en bloc removal of neoplasms. This approach remains the standard of treatment for lateral nasal wall tumors.