Purpose of ReviewReconstruction of the paranasal sinuses requires careful consideration of many factors, including cosmesis, structure, and function of adjacent anatomy. In this review, we describe approaches to reconstruction of the paranasal sinuses by highlighting options which restore form and function to these anatomic structures.Recent FindingsDepending on the subsites involved, defects of the maxillary sinus may affect the alveolar ridge, palate, orbital floor, and/or orbital contents. Prosthetics may be considered for many defects. Rigid reconstruction is recommended for certain defects, while others can be sufficiently reconstructed with soft tissue-only options. Reconstruction of anterior skull base defects focuses on the restoration of a water-tight dural seal to prevent cerebrospinal fluid leak.There are non-surgical, local, regional, and free flap options for reconstruction of the paranasal sinuses. Reconstructive efforts should focus on restoring the anatomic functions affected by the defect.