Allergic fungal rhinosinusitis is a non-invasive disease most commonly found in immunocompetent host. In present study we aim to study the role of itraconazole as primary medical management in Allergic Fungal rhinosinusitis in improving treatment outcome and its role in avoidance of surgery. Total of 50 patients of clinically diagnosed AFRS equally divided into 2 groups, one group receiving 3 months of itraconazole and other receiving steroids in tapering dose. Outcome measures used were-nasal endoscopy (Kupferberg score), symptom score (SNOT-20), NCCT-nose pns orbit (Lund-Mackay score) and biochemical, immunological markers with secondary outcomes of adverse effects and avoidance of surgery.