Background: There is a wide range of anatomical variations affecting the nose, paranasal sinuses (PNS) best diagnosed by Computed Tomography (CT). These variations may cause impairment of mucociliary drainage of the PNS resulting in sinusitis. Objectives: In this paper, the aim is to study the relationship of the anatomical variations of the lateral nasal wall, nasal septum and paranasal sinuses with the occurrence of chronic rhinosinusitis. Methods: The study included two groups of patients, the first has chronic rhinosinusitis while the second was without chronic rhinosinusitis. Anatomical variations of nose and paranasal sinuses which are nasal septal variations, concha bullosa, agger nasi cells, haller cells, paradoxical middle turbinatesand uncinate process variations were detected in both groups to investigate the relation between the anatomical variations and chronic rhinosinusitis. Results: A case control study was done which showed that there a significant statistical relation between nasal septal deviation and chronic rhinosinusitis. Conclusion: There was a significant relation between nasal septal deviation and chronic rhinosinusitis.