Endoscopic sinus surgery (ESS) was previously restricted only to tackling pathological conditions in the nose and paranasal sinuses like chronic sinusitis and nasal polyposis. Over the years the scope of ESS has considerably widened with the nasal endoscope now being routinely used to access even the surrounding regions like the orbit, optic nerve, lacrimal sac and the pituitary gland to name a few. Similarly CSF leaks which previously required external craniotomy procedures can now be safely and effectively closed by the endoscopic trans-nasal approach. The chief advantages of the endoscopic route are decreased morbidity and better cosmesis wherein external scars are avoided.