Chronic rhinosinusitis (CRS) is a prevalent disease that causes persistent mucosal inflammation and is associated with bacterial infection, which is thought to play a role in the inflammatory process. Microbiome analysis provides insight to host-microbial interactions. Disturbances in the host and commensal bacteria interaction may lead to CRS. Culture-based methods are useful to isolate some microorganisms but are unable to grow a majority of the bacteria. A review of the literature shows that several recent studies attempted to overcome this issue by using molecular techniques, such as microbial RNA sequencing, to describe the CRS microbiome. All of these studies were performed in adults, with no comparative studies reported in the pediatric population. Similar studies, utilizing molecular techniques, are needed to better understand the mechanism of CRS in children. Because valuable data from these adult studies may help to bridge the gap in our knowledge of the microbiome in pediatric CRS, we present an overview of the methodology and results behind the current microbiomic approach to adult CRS to set the stage for its use in the study of CRS in children.Keywords: microbiome; pediatric chronic rhinosinusitis; molecular techniquesThe field of the microbiological study of chronic rhinosinusitis (CRS) in adults has taken a quantum leap forward in only a few years. Unfortunately, similar approaches to the study of CRS in children have been totally lacking in the literature. A Medline search was performed for articles reporting on the microbiome in patients with CRS. Search terms included: 16S ribosomal RNA (rRNA) gene sequencing in chronic rhinosinusitis, chronic rhinosinusitis and microbiome, chronic rhinosinusitis and pyrosequencing, non-cultured molecular techniques in chronic rhinosinusitis, microbiome and 16S ribosome RNA. The following is an overview of the reported methodology and results behind the current microbiomic approach to adult CRS with the goal to set the stage for its use in the future studies of pediatric CRS.Bacterial rhinosinusitis is one of the most common problems presented to the primary care physician's office and results in over $5 billion in direct costs annually [1]. CRS symptoms lasting >12 weeks with or without exacerbations, affects more than 30 million Americans, which results in over $2.4 billion in annual health care expenditures [2]. CRS is considered an inflammatory disorder of the paranasal sinuses. Analysis of direct microbial cultures, sinus secretions, and tissue samples has demonstrated the presence of bacteria. It has been speculated that the bacterial colonization in CRS plays a role in pathophysiology of the disease [3,4]. Despite these findings, the role of microbial stimuli causing inflammation in CRS remains controversial [5].