<p class="abstract"><strong>Background:</strong> Sinonasal diseases include a wide spectrum ranging from inflammatory conditions to neoplasms, both benign and malignant and with the advancement in medical sciences and technology, and the ability to detect and control most illnesses, time has witnessed a momentous evolutionary change in medical practice. Objectives of the present study was to assess the demographical profile of sinonasal diseases patients and to compare the role of X-ray and computed tomography (CT) in the diagnosis of sinonasal diseases.</p><p class="abstract"><strong>Methods:</strong> The study was conducted on 100 cases presenting in the ENT OPD, patients admitted in ENT ward and cases referred from medical and surgical departments of G. R. Medical College and J. A. Group of Hospitals, Gwalior, who had chronic sinonasal symptoms. All the collected data was analyzed using SPSS15.0 and frequencies, validity of both the modalities were compared.  </p><p class="abstract"><strong>Results:</strong> The mean age was 33.75 years with youngest patient of 5 years and oldest being 85 years of age. CT had a good sensitivity and specificity for bacterial sinusitis (95.1%, 93.2%), fungal sinusitis (80%, 97.9%), single nucleotide polymorphism (90%, 88.6%), benign lesions (75%, 97.7%), malignant lesions (78.6%, 98.8%) respectively with a p value of &lt;0.001, reflecting a highly significant level.</p><p class="abstract"><strong>Conclusions:</strong> Present study proves the significance of CT in diagnosing sinonasal pathologies and guiding their management. However, the importance of X-ray as a preliminary investigation, especially in acute or chronic cases which cannot be ignored.</p>