Abstract Aerosol drug administration has a long history as an important part of the treatment for different respiratory disorders in both adult and paediatric patients. The nebulization process permits the drug delivery directly to the upper and lower airways tracts, allowing increased local effectiveness, and avoids systemic side effects. The aerosol therapy is mainly used in pneumology for lower respiratory tract disorders, a series of drugs having a proven efficacy. Few publications present the efficacy and safety of ENT nebulization, despite its worldwide utilization. Topical drug delivery to the nasal cavities and paranasal sinuses via aerosols appears to be an interesting, but also a challenging alternative. The transport and deposition of drugs and aerosol particles into the sinuses is debatable due to several factors: sinuses are poorly perfused and virtually non-ventilated cavities; they are protected by the efficient particle filtration function of the nasal cavities. The review evaluates the efficacy and safety of aerosol therapy in rhinologic pathology.