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Abstract : The main goals of endoscopic sinus surgery are providing a sufficient drainage and ventilation for paranasal sinuses. Partial resection of the middle turbinate is sometimes necessary to provide good surgical access to the middle meatus. To evaluate the surgical access and patency of middle meatus with clinical outcomes of endoscopic sinus surgery with and without partial middle turbinate resection. A prospective study has been conducted in otolaryngology department at Al-Immamain al- Kadhymain teaching hospital from August 2017 to September 2018 on 24 selected patients with bilateral chronic rhinosinusitis without nasal polyposis, didn’t respond to medical treatment. They managed by endoscopic sinus surgery and divided randomly into two groups: Group I with partial middle turbinate resection including 14 patients (28 sides operated). Group II with middle turbinate preservation including 10 patients (20 sides operated). Follow up was done weekly during 1st month, every other week during 2nd month and once during 3rd month. The patency of middle meatal antrostomy was 100% in group1 and 75% in group2. Adhesion was 3.6% in group1 and 30% in group 2. The duration of operation was shorter in group 1. Over all, symptoms improved in both groups. Partial middle turbinate resection can result in significant long-term patency of middle meatus and decrease in adhesions & shortening surgical time without any significant adverse effect, at same time preserve partially as surgical landmark.