Background <p>Full access to the frontal sinus is necessary for the effective treatment of some disorders affecting the frontal sinus, such as chronic frontal sinusitis [1,2]. This study aimed to evaluate the quality of life after endoscopic frontal sinus drill out procedures (Draf III. frontal drill out).</p> Methods <p>Thirty patients were admitted between June 2019 and June 2022 for Draf III as guided by endoscopic examination and CT information related to demographics, 22-item Sino-Nasal Outcome Test (SNOT-22) score, and endoscopic ostium assessment were recorded with a minimum follow-up of 6 months.</p> Results <p>There were 30 patients (13 men and 17 women, age range (20–60) years. Pathology of the frontal sinus disease was chronic rhinosinusitis with nasal polyposis (CRSwNP) (12 patients), chronic rhinosinusitis without nasal polyposis (CRSsNP) (11 patients), and (7) patients presented with other pathologies. We reported ostium patency 6 months postoperatively with patent frontal ostia in 54 out of 60 sinuses (90%). Patients had a significant improvement in the total mean SNOT-22 (40.62 ± 19.66) preoperatively and was reduced to (13.47 ± 10.87) 6 months postoperatively. In addition, each of its mean subscale scores was reduced. There was also significant SNOT-22 individual item level improvement postoperatively in all items. No major complications were recorded in our series.</p> Conclusion <p>In carefully selected patients with frontal sinus disease, Draf III procedure offers a very significant improvement in their quality of life.</p>