According to World Health Organization (WHO, 1991) papillomas of nasal cavity is subdivided in three main histopathological types: 1) Inverted papilloma; 2) exophytic papilloma; 3) vestibular papilloma. In particular, inverted papilloma represents 0.5%-4% of all nasal tumors and is characterized by local aggressivity and malignant evolution. During the years controversies arose about therapeutical treatment of inverted papilloma, with different results concerning conservative treatment (endoscopic resection; Caldwell-Luc operation) and an external approach resection (Weber-Fergusson approach). Our clinical experience is related to 33 patients submitted to surgery for inverted papilloma of nasal and paranasal cavity in the period 1982-1993. Diagnostic method was based on endoscopy and CT/RM integration in order to demonstrate local extension of tumor and to plan surgical approach. In particular 8 patients were submitted to endoscopic surgical approach (small and anterior papillomas). In 10 cases we performed a combined approach (endoscopic microsurgery plus Caldwell-Luc approach) and in 15 patients an external approach was carried out. Long-term results of the therapy are presented and discussed and a review of Literature is carried out.