Abstract
Sphenoid sinus disease is recognized as an unusual clinical entity. It is likely that it is under-reported because of its lack of recognition as it has an insidious onset with nonspecific symptoms. Further, optimal physical examination is difficult because of the relative inaccessibility of the sinus. During the past decades, endoscopic sphenoid surgery has been the standard approach worldwide. There are many variables to be considered while selecting the best endoscopic approach to the sphenoid. In this work, the author describes different endoscopic approaches to the sphenoid with their clinical application.