This study included 28 adults prospectively enrolled between March 2011 and May 2013 into a non-randomised, multi-institutional cohort. Adults electing endoscopic sinus surgery experienced gains in olfaction comparable to adults electing continued medical management. The evidence in this study comparing the impact of medical and surgical management of chronic rhinosinusitis on olfactory function is limited. Further study with larger sample size and more sensitive measures of olfaction are needed to determine differences between treatment groups.