Pediatric neoplasms of the sinonasal tract and skull base differ from adults by their lower incidence, pathology, and location. Presenting signs vary and are directly related to the tumor location and size. Treatment strategies are as diverse as the pathologies being addressed, which include both benign lesions and malignancies. Surgical approaches must adapt to the peculiarities of the maturing pediatric facial skeleton and a narrow sinonasal corridor. Radiation therapy for pediatric patients must be delivered carefully as radiation exposure to the maturing brain is known to cause neuroendocrine dysfunction and chronic comorbidities. Overall, pediatric neoplasms carry an overall better prognosis than in adults as pediatric tumors are more likely to be benign and are able to be completely resected surgically.