A group of 31 patients with inverted papilloma were treated at the Mount Sinai Medical Center. There were no multicentric cases, and one patient had an associated malignancy. A conservative procedure consisting of intranasal or transantral sphenoethmoidectomy was selectively performed in 8 patients with limited lesions. No recurrences were observed in this group after a mean follow-up of 2 years. Lateral rhinotomy with medial maxillectomy and en bloc resection of the ethmoid labyrinth was performed in 23 other patients. One recurrence appeared in this group, members of which were followed a mean of 3.8 years. Radiographic evaluation by multidirectional polytomography and CT scanning permits identification of a small group of patients who have limited lesions and may be candidates for conservative tumor excision.