The orbit and the sinonasal area have intimate relations. Lesions in both areas may extend to the other and surgical intervention of any may harm the other.The transnasal endoscopic approach is the most direct with no facial scar and usually one day case. Endoscopic transnasal surgery can be used in orbital surgery. From this transnasal approach, the anterior skull base, the medial and inferomedial orbits, the orbital apex with the optic nerve, and the inferomedial intraconal compartment of the orbit are within reach.The transnasal approach is not indicated in all diseases that are situated mostly intraconal, supraorbital, and lateral of the eyeball, or for tumors with intracranial extension. So, one should be ready for external approach in case of failure to achieve good exposure and/or complete excision of the orbital lesions.Co-work between Rhinologists and Ophthlmologists is mandatory for better care of patients with such lesions.