Functional endoscopic sinus surgery under local anaesthesia with one single intramuscular injection of systemic premedication (pethidine and promethazine) and careful local preparation (decongestive nose drops, cocaïne application and lidocaine infiltration). It is well tolerated and accepted in 95% of the patients. Blood loss is minimal and pain during the operation is rare. Major and minor orbital and intracranial complications were not seen. Local anaesthesia with this kind of surgery offers many advantages and is preferable to general anaesthesia when possible.