The primary purpose of this guideline is to improve diag- nostic accuracy for adult rhinosinusitis, reduce inappropri- ate antibiotic use, reduce inappropriate use of radiographic imaging, and promote appropriate use of ancillary tests that include nasal endoscopy, computed tomography, and testing for allergy and immune function. Secondary goals include creating a guideline suitable for deriving a performance measure on rhinosinusitis and training participants in guide- line methodology to facilitate future development efforts. The guideline is intended for all clinicians who are likely to diagnose and manage adults with rhinosinusitis, and applies to any setting in which an adult with rhinosinusitis would be identified, monitored, or managed. This guideline, however, does not apply to.