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Background: Sinusitis is an inflammation of the paranasal sinuses that can be caused by anatomic variations of the nasal cavity and paranasal sinuses. In this study we aimed to find the relationship between sinusitis and septal deviation (SeD) and concha bullosa. Methods: Two trained resident of ENT evaluated sinus CT scans of 463 cases presenting with nasal obstruction or chronic sinusitis symptoms from April 2011 to December 2011. CT scans were checked for the presence of conchae bullosa and the degree of septal deviation. The severity of sinusitis was evaluated according to the Lund Mackay criteria. The frequency of patients with different degrees of SeD and different grades of chronic sinusitis were studied. Results: Of 463 cases, 47% had septal deviation. Concha bullosa was seen in 16.8% of the patients in the left side and 27.6% of them in the right side. There was no significant relationship between the presence of concha bullosa and the severity of sinusitis. Also the P value of analytical tests between the severity of sinusitis, osteomeatal involvement and the degree of septal deviation was not significant. Analysis of the relationship between the presence of SeD (either to right or left) and the severity of sinusitis in different sinuses revealed no significant P value. Conclusions: By this study, the relationship between concha bullosa in osteomeatal complex and the severity of sinusitis was not cleared. No relationship was found between the severity of sinusitis, osteomeatal involvement and the degree of septal deviation. Also SeD (either to right or left) was not found to be associated with the severity of sinusitis in different sinuses. [ABSTRACT FROM AUTHOR]