In the practiceof rhinology opacity of maxillary antrum figures frequently and prominently in radiological reports, and often the case is treated as chronic maxillary sinusitis but due to presence of wide variety of conditions like anatomical factors and technical factors which can give rise to opacity of maxillary antrum, it is dangerous trend to think mostly in terms of chronic infection and subject the patient to undue repeated antral punctures or radical antral surgery. An opaque maxillary anturm should be treated as a sign and not as a definite diagnosis and an attempt should be made to pin point the cause of the maxillary sinus opacity preferably with the help of sinus endoscopy.