This chapter provides a comprehensive overview of anaesthesia management in maxillary sinus surgery, particularly focusing on endoscopic sinus surgery. While topical and local anaesthesia is suitable for minor procedures, general anaesthesia is essential for extensive resections due to its ability to provide optimal patient immobility, airway protection, and hemodynamic control. This chapter details the importance of preoperative evaluation, effective airway management, and the use of controlled hypotension to minimize intraoperative bleeding. It also discusses the advantages and risks of different anaesthetic techniques, including deep versus awake extubation, and offers strategies for postoperative care, emphasizing the prevention of nausea, vomiting, and pain. This guide aims to optimize anaesthetic approaches to improve surgical outcomes and patient safety in maxillary sinus procedures.