Chronic rhinosinusitis (CRS) is a very prevalent inflammatory disease. Treatments vary in different countries. In the present study, we explored the approaches of physicians in 50 countries. In this cross-sectional study, a rhinosinusitis survey (RSS) was completed by Honorary and Corresponding Members (otorhinolaryngologists) of the Italian Society of Rhinology. In 79.1% of the 50 countries, the proportion of patients suffering from CRS was 15%. Nasal symptoms were more intense in winter (46% of countries), and spring and autumn (22%). The most common symptoms were nasal obstruction (86%), postnasal drip (82%) and headache (52%). The most common investigative modalities in the assessment of CRS are paranasal sinus CT, fiberoptic endoscopy, and anterior rhinoscopy. CRS patients were principally treated by otorhinolaryngologists (70%). Medical treatments included nasal corticosteroids (90%), nasal washes (68%), and nasal decongestants (32%). In 88% of countries, more than 50%, or "about 50%", of all patients reported subjective symptom improvement after treatment. In most of the countries, surgery was required by 20-35% of all CRS patients. During post-surgery follow-up, nasal washes (90%), nasal corticosteroids (76%), and systemic antibiotics (32%) were prescribed. In 20-40% of all patients, CRS was associated with nasal polyps. In such patients, the medical treatment options were nasal corticosteroids (90%), systemic corticosteroids (50%), nasal washes (46%), and systemic antibiotics (34%). Treatment of CRS patients varies in different countries. Paranasal sinus CT is the most common investigative modality in the assessment of CRS, and nasal corticosteroids are the first-line treatment, in the absence or presence of nasal polyps.