Sinonasal malignancies are rare tumours and, in the UK, are usually treated in tertiary treatment centres but may well be followed up long term in the patient’s local hospital, so advice on how best to manage these patients is invaluable. Recurrence rates vary greatly depending on tumour type and so, in this analysis, the authors sought to identify the optimal surveillance strategies and duration of follow-up required. Within the database used for analysis, there were 81 sinonasal malignancies, and the authors describe in detail the tumour recurrences as related to tumour type, modality of treatment, and stage of disease at presentation. Interestingly the overall five-year survival rate was 60.9% and patients treated surgically fared better than those treated with radiation or CRT. The majority of those who developed recurrence did so in the first two-to-three years, and almost all recurrences were within the first five years, although some late occurrences were observed. If recurrence was detected via nasendoscopy, it was more likely to be suitable for salvage surgery. If the failure was detected by imaging, it was less likely to be surgically treatable, however PET-CT and MRI are both invaluable in the follow-up of these patients and is complementary to routine clinical surveillance in the outpatient setting. The details are too diverse to report here, but this paper makes interesting reading for any clinicians involved in the follow-up of sinonasal cancer patients.