Purpose <p>The purpose of this retrospective study is to evaluate imaging features of sinonasal NK/T-cell lymphoma, potentially aiding early diagnosis and improving patient outcomes through timely biopsy evaluation and treatment.</p> Materials &amp; methods <p>This study was designed as a retrospective review. Imaging characteristics in a total of 28 patients with histology confirmed sinonasal NK/T-cell lymphoma were evaluated by two radiologists. Demographic data and clinical features were extracted from the electronic medical record.</p> Results <p>Among 28 patients, 84.6% presented with nasal cavity involvement and 88.5% with an isoattenuating lesion on CT and 63.6% with T2 hypointensity on MRI. Notably, 57.7% showed osseous destruction and 27.3% had devascularized tissue, highlighting significant radiologic features that may overlap with non-neoplastic etiologies.</p> Conclusion <p>Sinonasal NK/T-cell lymphoma should be in the differential diagnosis in patients presenting with chronic sinonasal symptoms and imaging findings of tissue necrosis, osseous destruction, and adjacent fat infiltration. Imaging features overlap with entities such as aggressive fungal sinusitis and granulomatosis with polyangiitis.</p> Graphical abstract <p></p>