Objective: This study aims to use macrolides as alternative to steroid in management of nasal polyposis. Background: Allergic nasal polyps are benign and are characterized by mucosal inflammation and expansion into the lumen of the nasal cavity. The treatment of these lesions can include steroids, saline nasal spray, mucolytics, topical/ systemic decongestants, topical anticholinergics, anti-leukotrienes or receptor blockers, and antihistamines, but steroids are the most effective drugs for medical polypectomy. Patients and Methods: 96 patients with persistent bilateral nasal obstruction were included in our study during period from January 2017 to December 2018. 42 patients used oral steroid as group B and 54 patients used oral macrolides as group A. Patients were scheduled for follow-up visit (after three months) with respect to computed tomographic scan of paranasal sinuses scoring and endoscopic nasal scoring. The severity of polyposis was significantly lower in the macrolides group vs. the steroid group based on both radiological and endoscopic scoring. Non-significant difference detected in the patient satisfaction between both groups. Conclusion: Macrolides are significantly effective drug in the management of nasal polyposis rather than steroid especially in cases contraindicated to use steroid in the regimen of management.