By two decades, there is increasing rate of fungal sinusitis and could be a fatal condition. CT and MRI are modalities for diagnosis. Forms of disease are invasive and non-Invasive. Clinically it could be divided to acute invasive, aggressive osseous destructive, chronic invasive, chronic granulomatosis, allergic and fungus ball. Infection could be occur in normal and immune compromised persons. Rare condition of fungal osteomyelitis could be happened after malignant external otitis in diabetic patients. Bone destruction, calcified material and no-response to medical treatment are hallmarks of fungal infection in PNS and skull base. fungal elements could be mucoraccae or mucormycosis “common”, aspergillus, mycetoma and ….