Abstract: Objective: To investigate the effects of different endoscopic surgery approaches in the treatment of maxillary sinus benign lesion. Methods: Thirty-nine cases with maxillary sinus benign lesions were treated with four different surgical approaches，which included 18 with the nasal passage to expand natural opening approach，9 cases with double approaches under the middle and inferior nasal passage, 11 cases with enlarging the natural openings of maxillary sinus combined with nasal lateral wall resection approach and 1 case with traditional Caldwell-Luc approach. results: All patients were followed up for 6 to 12 months, 30 cases cured，7 cases improved and 2 cases recurred. One case with inverted papilloma recurred，who was diagnosed with papillary squamous cell carcinoma by pathology after operation and lost to follow-up after radiotherapy. One case with maxillary sinus cyst ocurred in other parts of the maxillary sinus in 8 months after operation，who was untreated because the cyst was small and no clinical symptoms. Conclusions: Different endoscopic surgery approaches can be selected according to the characteristics of maxillary sinus benign lesion，which can improve the clinical effect and reduce surgical trauma.