The advent of endoscopic techniques have refined the management paradigm for paranasal sinus tumors. Inverted papilloma, the most common benign sinonasal tumor, remains an important surgical entity in the endoscopic era. The locally aggressive nature, high risk of recurrence with incomplete resection, and association with malignancy add to the management dilemma. This course will provide practicing otolaryngologists and trainees with up-to-date information on the pertinent pathophysiology, clinical features, diagnostic workup and management schema of inverted papilloma. The relevant pathophysiologic mechanisms, including the role of HPV, p53, and concurrent inflammation will be discussed. The diagnostic workup, including the role of endoscopy and biopsy will be outlined. The salient radiographic features noted on CT and MR imaging will be reviewed. The paradigm for minimally invasive endoscopic resection utilizing surgical navigation will be discussed. The role of medial maxillectomy, Denker’s procedure, endoscopic modified Lothrop, extended sphenoid approach, and adjunct open approaches to achieve tumor removal will also be elucidated. Management of specific subsites for maxillary, ethmoid, sphenoid and frontal sinus IP will be reviewed utilizing case based scenarios. Management of IP with skull base, lacrimal, or orbital extension and IP with carcinoma will also be discussed. Surgical outcomes, with special attention to recent systematic reviews, will be detailed. Clinical case examples will be utilized throughout the expert series to illustrate management pearls to optimize treatment outcomes for this neoplasm.