BACKGROUND Sinusitis is a leading health care problem believed to be increasing in both incidence and prevalence. Various articles have been published on sinusitis and its treatment. However, its importance is diminished by the fact that sinusitis is variously defined. The main objective of this study is to define the clinical signs and symptoms of chronic bacterial sinusitis and to grade the severity of presentation of each clinical feature correlating with radiological and endoscopic and microbiological features. MATERIALS AND METHODS This prospective study was conducted in a tertiary health care centre over a three-month period; 80 patients were chosen, 40 with nasal symptoms as their main complaint with or without headache as experimental group and 40 patients with headache as their main complaint without nasal symptoms as the control group. They were subjected to detailed clinical examination, radiological, endoscopic and microbiological examinations. RESULTS Nasal obstruction, discharge and headache form the major symptoms while hyperaemia, deviated septum with hypertrophied inferior turbinates form the major signs in the case group. Diagnostic nasal endoscopy correlated well with clinical findings, while x-ray of the sinuses was found to be abnormal in all cases. CONCLUSION A proper and detailed clinical evaluation with x-ray of the paranasal sinuses and endoscopy should form the mainstay in diagnosing chronic bacterial sinusitis. CT scan should be added if we are planning for surgery and for cases not responding to initial medical management due to radiological risk and cause factor.