OBJECTIVE To evaluate the clinical effects of implementing the use of a navigational system in sinus surgery in a community hospital setting. STUDY DESIGN Retrospective record review. METHODS The hospital records of 800 patients who had undergone sinus surgery performed by 7 physicians at one institution over 11 years were reviewed and tabulated. The information was recorded in 2 groups of 400 with those in group A being treated before the availability of an electromagnetic sinus navigational system and those in group B being treated after the unit had been installed. The following data were collected: date, age, gender, informed consent, physician, additional procedures, sinuses entered, use of navigational system, revision status, setup time, operative time, and complications. The results of the two groups were analyzed statistically, and comparisons were made. RESULTS/CONCLUSIONS The patient populations in groups A and B were determined to have similar demographic profiles. Significantly more sinuses, specifically in the frontal location, were entered in group B compared with group A. Adjusted for the number of sinuses treated, the median operative times did not differ significantly between groups. Major and minor complication rates were similar in both groups and were consistent with the published literature. In a community hospital setting, once an electromagnetic guidance system became available, it was used in 92% of the cases performed by sev-eral otolaryngologists.