Purpose <p>Endoscopic sinus surgery (ESS) is commonly performed to improve sinonasal complaints and enhance quality of life (QoL) for patients with chronic rhinosinusitis (CRS). Significant research has been published examining the efficacy of ESS in various domains that encompass CRS.</p> Methods <p>A systematic search of PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases was conducted. The review was performed following the PRISMA guidelines. Systematic reviews with or without meta-analyses (SRMA) investigating the efficacy of ESS in CRS patients were retrieved. All other study designs were excluded. A qualitative review of the published literature was performed.</p> Results <p>A total of 55 SRMAs met the final inclusion criteria. Most studies examined outcomes through patient reported outcome measures (PROM) such as the sinonasal outcome test (SNOT). Ten studies investigated the efficacy of ESS in comorbid conditions such as asthma or aspirin exacerbated respiratory disease (AERD). The remaining studies evaluated the role of intraoperative adjuncts, perioperative treatments, or the timing or extent of surgery.</p> Conclusions <p>ESS has significant, broad, and long-lasting positive impacts on a host of sinonasal domains. This systematic review of systematic reviews demonstrates the current breadth of research examining the efficacy of ESS for patients with CRS. Continued high quality research will improve outcomes and advance discovery.</p>