PURPOSE OF REVIEW: To set the context of current knowledge regarding the role of herbal medicine in acute and chronic rhinosinusitis treatment. RECENT FINDINGS: It is estimated that adults experience 1-3 episodes of viral rhinosinusitis per year and this number increases up to 8-10 episodes in preschool children. The symptoms of acute rhinosinusitis tend to significantly overlap with symptoms of other upper respiratory infections, making the diagnosis quite difficult. The division of rhinosinusitis into bacterial or non-bacterial is clinically important in order to determine appropriate treatment and the administration of antibiotic treatment. Treatment of acute rhinosinusitis is symptomatic and includes nasal rinsing, decongestants, corticosteroids, and combinations of the above. Herbal medicine has been traditionally underestimated in Western world. Nowadays, however, treatment of diseases with the use of medicinal plant treatments is gaining more and more followers. In this context, certain herbal extracts have been tested for viral, post- viral and chronic rhinosinusitis. Phytoneering is an innovative pharmaceutical technique in research and production of herbal medicines. Herbal extracts produced with phytoneering vary in quality and active substances. In terms of quality, safety and efficacy, herbal medicines are at least on par with synthetically produced medicines, having significantly less unwanted side effects. Certain herbal extracts have been tested, and in cases of acute rhinosinusitis are effective. In chronic sinusitis those extracts show promising results and might prove a good alternative without side effects.