Balloon sinuplasty has been part of the sinus doctor tool chest now for 12 years. Following a not dissimilar path that cardiac balloon angioplasty did, it has gone through the experimental phase, the careful adopter phase, the insurance company pushback phase, and now has entered the era of acceptance and excitement. It has rapidly become the standard of care for treating patients with long standing symptoms of sinusitis - headaches, facial pain, discolored drainage, nasal obstruction, nasal congestion, and/or unremitting chronic cough. To date, over one hundred thousand of these procedures have been performed. The success rate in the appropriately selected patient is extremely high, rivaling that of endoscopic minimally invasive sinus surgery.