Corticosteroids are among the most frequently prescribed medications by the otolaryngologist. The indications for treatment are well defined for some diagnoses, such as sudden sensorineural hearing loss and nasal polyposis. For other diagnoses, such as allergic rhinitis and acute upper respiratory infections, the evidence is lacking. Recent studies have shown wide variation in steroid prescribing across the United States, in many cases against the dictates of evidence-based medicine. This panel presentation will address the most common indications for use of oral or intramuscular steroids in the ear, nose, throat, head and neck. Focus will be specifically on systemic steroids as distinct from topical steroids such as sprays or drops. The concept of steroid stewardship will be introduced as a responsibility of the clinician in providing optimal patient outcomes and minimizing harms.