Abstract: Objective To describe clinical features and treatment of nasal sinus mucocele in order to reduce missed diagnosis and misdiagnosis. Methods Clinical data, imaging data and surgical procedures of 22 patients (12 males and 10 females with average age of 42.2 years old) with nasal sinus mucocele in Hainan Branch of Chinese PLA General Hospital and First Affiliated Hospital of Henan University from December 2012 to December 2017 were retrospectively analyzed. Precautions and complications during the operation were also analyzed. Results The main clinical symptoms of nasal sinus mucocele were exophthalmos, ophthalmalgia, visual impairment, ambiopa, epiphora, headache, nasal obstruction, face swelling, maxillary toothache. Imaging examination showed that frontal sinus was involved in 7 cases, ethmoid sinus in 6 cases, sphenoid sinus in 2 cases, maxillary sinus in 2 cases, frontoethmoidal sinus in 4 cases and spheno-ethmoidal sinus in 1 case. All lesions were resected successfully by nasal endoscopic surgery,the cyst cavity was well drained, and symptoms were alleviated. Conclusion The clinical symptoms, signs and CT/MRI fi ndings are helpful in the diagnosis of nasal sinus mucocele. Endoscopic excision and drainage is an ideal method for nasal sinus mucocele.