BACKGROUND: There is limited consensus on management protocols and practice patterns following endoscopic skull base surgery (ESBS). METHODS: An online-based survey focusing on ESBS practice patterns was anonymously distributed to the American Rhinologic Society, North American Skull Base Society, and American Head and Neck Society Skull Base Section membership. RESULTS: A total of 130 surgeons (81.5% in academic positions) completed the survey. Regarding reconstructive materials, 36.9% always used autologous as opposed to synthetic materials, with variation in specific materials used. Lumbar drain was never used by 22.3% of respondents, while high BMI or suspected intracranial hypertension (43.1%) and high-flow leak or large dural defects (50.0%) were indications for lumbar drain usage. There was significant variation in types of nasal packing, type, and duration of postoperative activity restrictions, antibiotic use, and debridement protocols. CONCLUSION: Postoperative management following endoscopic skull base reconstruction is highly complex, with a wide variety of practice patterns. LEVEL OF EVIDENCE: N/A.