Endoscopic surgery is a viable treatment alternative in thesurgical armamentarium of management of inverted papilloma.However, larger patient populations and longer follow-upperiods are needed for more definitive results. Furthermore,there are compulsory preconditions for successful endoscopicsurgery of the inverted papillomas such as good preoperativestaging, a surgeon experienced in this technique, adequateendoscopic equipment, and a close follow- up of the patients.Before considering endoscopic surgery, the patient mustbe informed about the nature of the disease and the necessity ofa close follow-up. Furthermore, the patient must know that theendoscopic approach may be combined with a radical surgery.The choice of the surgical approach should be made accordingto the location and extension of the tumor and experience of thesurgeon; so far there has been no consensus about the exactindications of endoscopic surgery.Long-term endoscopic surveillance and frequent followupcare are crucial, regardless of the surgical technique used.Treating disease recurrence early may prevent malignanttransformation. Recurrence is mostly detected endoscopically in12-20 months but reported as late as 30-56 months.