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The endoscopic technique does not substitute traditional resections but is highly useful to improve visualization during these approaches and reduces morbidity. We describe 18 malignant tumors of the paranasal sinuses treated through endoscopic-assisted cranionasal resection between November 2000 and March 2007. Treatment was completed with chemotherapy and/or radiotherapy. The surgical approaches and the technique used are described. Patient follow-up ranged between 12 and 60 months (mean: 33 months). Local recurrence occurred in three patients (17%) and distant metastases in two (11%). The technique has lower morbidity than craniofacial approaches since it avoids facial incisions. There were no cerebrospinal fluid leaks and the patients were discharged within a week. The advantages of endoscopic-assisted cranionasal resection are that it improves results and reduces morbidity in the treatment of malignant tumors of the skull base.