Nanotechnology and nanomedicine are new and rapidly developing areas which are concerned with the utilisation of structures and devices, one billionth of a metre in scale and how their special properties may be utilised in the diagnosis and treatment of diseases. In otorhinolaryngology, there have been some inroads into utilising these new treatment modalities and there is future prospect for significant developments. Their impact may be to revolutionise the current practice of otorhinolaryngology. This review considers current developments and future prospects for nanotechnology in our specialty and considers the pitfalls that may be encountered. The online medical reference databases PubMed, Google Scholar, ISI Web of Science and Science Direct were searched with search terms "Nanotechnology, Nanomedicine" in combination with "Otolaryngology, ENT, Rhinology, Otology, Head and Neck Surgery, Laryngology" in turn. A number of developments are already showing promise in animal models, particularly for nanoparticle delivery of drugs, which may avoid some of the inherent systemic side effects seen with conventional application. Other possibilities include nanoscale reconstruction and regeneration of tissues and even unexpected spin-off technologies such as haemostatic agents. The future treatment of otorhinolaryngological diseases could be revolutionised by advances in nanomedicine and nanotechnology and diseases, such as olfactory disorders may become radically more amenable to medical treatment.