The widespread use of endoscopes for diagnosis and treatment of sinonasal diseases has led to a renewed interest in the surgical anatomy of the nose and paranasal sinuses. With an understanding of the relationships of the structures within the anterior ethmoid sinuses, particularly the frontal recess, safer and more successful management of disease is possible. Identifying anatomic variants on preoperative computed tomograms and intraoperatively makes injury to posterior skull base structures less likely. Familiarity with nasal and sinus anatomy not only increases surgical skill but also adds to the understanding of developmental changes within the sinuses of children, which may influence treatment options. Comprehending the sinonasal embryology is also useful in explaining recently reported congenital nasal abnormalities.