<p>Purpose of review: The primary objective is to provide insight into the limited available information, aiding in the effectiveness and safety of radiation therapy in treating sinonasal inverted papilloma which is a rare but challenging disease. Recent findings: Radiation therapy is a crucial supportive element in the management of sinonasal inverted papillomas, which usually originate from the respiratory mucosa of the sinonasal tract, even though surgical excision is still the gold standard for treating these tumors.Although sinonasal inverted papillomas are primarily histologically benign, they are aggressive locally and have a high propensity to recur. Their intricate growth patterns and proximity to critical structures present complex surgical challenges. Additionally, at the time of first diagnosis or recurrence, there is a 5–15% chance of malignant conversion to inverted papilloma squamous cell carcinoma.Consequently, long-term surveillance is essential due to the above factors.Radiation therapy is beneficial in specific clinical scenarios.When surgical margins are positive, adjuvant radiation therapy usually helps target and eliminate microscopic subclinical illness, lowering the chance of local recurrence.Furthermore, for patients for whom surgical intervention is not possible because of anatomical constraints or patient-specific reasons, definitive radiation therapy, either alone or in conjunction with chemotherapy, plays a viable, effective treatment option. Summary: There is still no consensus on radiation therapy use in treating sinonasal inverted papilloma, despite the fact that the retrospective investigations have shown its potential benefits since the early 20th century.In order to fill this knowledge vacuum, a comprehensive analysis of the body of research covering this difficult tumor was carried out using databases including Pubmed, Google Scholar, and Scopus.</p>