Atrophic rhinitis is an uncommon and distinct clinical syndrome of progressive atrophy of the nasal mucosa. It is characterized by paradoxical nasal congestion and thick, troublesome nasal secretions and complicated by bacterial colonization and infection. Enlargement of the nasal cavities may occur in some forms. Most patients also have concomitant sinusitis and thus, the disorder is more accurately called atrophic rhinosinusitis. Th ere are primary and secondary forms of this disorder, which aff ect diff erent populations and have distinct presentations. Th is topic will discuss the classifi cation, clinical manifestations, diagnosis and management of atrophic rhinosinusitis. Other forms of chronic rhinosinusitis are reviewed separately.