Background: There is a wide range of anatomical variations affecting the nose, paranasal sinuses (PNS). These variations may cause impairment of mucociliary drainage of the PNS resulting in sinusitis. Aim: The aim of this study was to determine the incidence of anatomic variations of the different structures of the nose in a group of patients with chronic rhinosinusitis without nasal polyposis and compare them with cases didn’t have sinusitis. Methods: This case control study included 140 patients who had diagnostic criteria of CRS according to EPOS 2020. Cases were collected from February 2020 to February 2021 from the outpatient clinic of Otorhinolaryngology Department of Tanta University Hospital. Patients were divided into two equal groups: The first group was the study group including 70 patients who had chronic rhinosinusitis as detected by Computed tomography (CT) of paranasal sinuses. The second group was the control group including 70 patients who had normal CT of paranasal sinuses. Results: There was significant relation between the studied anatomical variations and chronic rhinosinusitis for Septal deviation, Haller cells, Supra agger frontal cell and Supra bulla frontal cell. Conclusions: The relation between anatomical variations and sinusitis is not clear till now. Some studies showed statistically significant association between common anatomical variations and the presence of sinusitis while in other studies no statistically significant relationship. In our study there was significant statistical relation between Septal deviation, Haller cells, Supra agger frontal cell and Supra bulla frontal cell and chronic rhinosinusitis.