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BACKGROUND: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a frequently diagnosed chronic disease that has been widely recognized as a significant economic strain on society. Recently, concern about the rising prevalence of eosinophilia in CRSwNP has attracted research interest. A comprehensive understanding of the characteristics and disease burden of CRSwNP patients may contribute to improved management of these patients. METHODS: We conducted a multi-center retrospective observational study based on real-world data. Patients were filtered into three groups: CRSwNP overall group, CRSwNP surgical group, and CRSwNP patients who had a relapse after surgeries. Furthermore, we used laboratory test results of blood eosinophil percentage (EOS%) as an indicator of eosinophilia. The comorbidities and medications of patients in the high and low EOS% groups were compared. Disease burden was measured from two aspects: direct costs and loss of working days. RESULTS: A total of 1,724 CRSwNP patients were eligible, 527 of which were filtered into the surgical groups. Only 16 patients in this study were found to have a relapse. The mean ages of the CRSwNP non-surgical, CRSwNP surgical, and CRSwNP relapse groups were 46, 47, and 52.5 years old, respectively. Most patients sought treatment in the otolaryngology department. Among all three groups, the most prevalent comorbidities were allergic rhinitis and asthma. The most prescribed drug was intranasal/oral corticosteroids. The direct costs per person/year for the non-surgical group, surgical group, and relapse group were ¥188.60, ¥15,190.00, and ¥14,160.00, respectively. The loss of working days per person/year for the non-surgical group, surgical group, and relapse group was 10.41, 24.40, and 21.65 days, respectively. CONCLUSIONS: CRSwNP is a disease of middle age. It is frequently associated with asthma and allergic rhinitis. Eosinophilia was found to have a considerate influence on patients’ treatment patterns. Based on available data, we noted that patients in the high EOS% group were more likely to have asthma and allergic rhinitis. Intranasal/oral corticosteroids were the most frequently used drug for patients with CRSwNP, while a smaller proportion of patients in the high EOS% group used intranasal/oral corticosteroids. The disease burden of CRSwNP is posing significant challenges to both patients and society.