Chronic sinusitis with nasal polyposis is becoming more widely recognized as a Type 2 inflammatory disease but the best treatment strategies for personalized patient treatment and which biomarkers to use to predict treatment success are still being investigated. For some patients, a complete FESS followed by medical therapy is successful at controlling disease recurrence. For others, this is not the case, sometimes requiring numerous additional surgeries to control the burden of disease. With the advent of FDA approved biologics for nasal polyps and additional Phase three trials combining biologic use with surgery, there is the potential to use available biomarkers and patient characteristics to direct therapy to minimize the need for further additional surgery and corticosteroid use. This panel uses patient cases with biomakers, images, and videos, as well as currently available evidence and guidelines, to discuss different therapeutic approaches to treatment and ways to potentially answer the questions: Who will do well with just surgery and medicated rinses? Who will need adjuvant biologic therapy or would need that treatment first?