Endoscopic modified medial maxillectomy (EMMA) is a more extended form of a traditional endoscopic maxillary antrostomy. Initially described for benign and malignant tumors, EMMA can also be performed in patients with recalcitrant chronic rhinosinusitis despite prior sinus surgery or those with a predilection for sinus inflammatory disease. EMMA involves an uncinectomy, resection of the posterior 2/3 of the inferior turbinte, and widening of the maxillary antrostomy to the posterior wall of the maxillary sinus and to the inferior meatus. Multiple retrospective studies have demonstrated the effectiveness of this procedure in improving recalcitrant chronic maxillary rhinosinusitis disease burden with overall low complication rates when performed by experienced surgeons.