Introduction: Frontal sinus fractures pose an interesting and challenging problem, as optimal treatment strategies for the management of frontal sinus fractures remain controversial. These fractures peculiarity is that a wrong treatment not only could it encompass functional or aesthetical problems but also more dangerous complications. Various techniques have been advocated to repair or remove the frontal sinus that largely depends on the mechanism and extent of the injury and the status of the nasofrontal duct (NFD). These operations include ablation, open reduction and internal fixation of the anterior table, obliteration, and cranialization. The lack of consensus regarding the treatment options may provide a motive to compare two different modalities in management of the comminuted anterior table fractures of the frontal sinus affecting nasofrontal duct i.e. obliteration of the sinus versus achieving transantral drainage to assess the efficacy of different modalities. Patients and Methods: This study was carried out on 20 patients selected from the Oral and Maxillofacial department, Faculty of Oral and Dental Medicine, Cairo University and the Cranio and Maxillofacial department, Naser Institute. The selected patients suffered of unilateral anterior wall fracture of their frontal sinuses approximating the nasofrontal duct and having intact posterior walls of their frontal sinuses. The selected subjects were randomly divided into two groups, Group I: (sinus Obliteration Group). Group II: Transantral Drainage Group where inter sinus septum (a) was removed to the level of the sinus floor and thus rendering the injured sinus in patent communication with the intact sinus. Clinical and radiographic evaluations were carried out at immediate post-operative, and at 6 and 12 months post operatively. Radiographic evaluation of the cases was done using computerized tomography (CT) scanning. Results: In the current study 90% of the included subjects were males and the mean age was 34years. In 60% of the studied sample the frontal sinus fracture was associated with other maxillofacial fractures, and in 40% of the series the frontal sinus fracture was unassociated with other fractures. In the present study the obliteration group has revealed a rate of total 40% complications. Whereas transantral drainage group in the current study has revealed a rate of 30 % complications, When the two groups were inter-related the difference was statistically insignificant this may point out the lack of consensus regarding the best management modality. The results of this study indicate that a functioning sinus can be preserved in the majority of patients with frontal sinus fractures. Also it could be concluded that frontal sinus obliteration will continue to be a workhorse operation in trauma management of anterior wall frontal sinus fracture. Moreover, Transantral Drainage could be a valid and conservative alternative in management of unilateral anterior frontal sinus fractures.