The relevance of polypous rhinosinusitis (PRS) is due to its high prevalence and no procedures for preventing a recurrent polypous process. Objective - to consider the development of polyposis over time in the context of labored nasal breathing, one of the major signs of polyposis, in relation to the age and gender of patients, the onset of labored nasal breathing, and the status of intranasal structures. Subjects and methods. The investigation enrolled 160 patients with new-onset PRS. The sample was selected from the total number of inpatients referred from different health facilities and insurance companies to the ENT Unit of the Central Clinical Hospital. Results. Nasal endoscopy and computed tomography could evaluate the nasal cavity and paranasal sinuses and the extent of a pathologic process. Most patients were found to have different variants of intranasal structural abnormalities. First of all, this was nasal septum deviation that required surgical intervention in 132 (82.5%) patients. Nasal endoscopic examination could reveal the early forms of PRS. Middle nasal passage endoscopy detected polyps originating from the uncinate process from the anterior surface of the ethmoidal bulla. Polyps most commonly started forming at the anterior end of the middle nasoturbinal and along its free edge to its posterior end. Computed tomography for grade III obturating polyposis provided a possibility of evaluating the nasal septum and turbinals since it was difficult to make an endoscopic examination of such patients. A long-term follow-up for 6 months to 4 years showed the following results. Twelve (7.5%) patients reported a recurrence; recurrent polyposis occurred in the period of 11 months to 2 years. Surgical retreatment was performed in all the patients with a disease recurrence. In a recurrence, there was generally grade I polyposis; polyps were located in the middle nasal passage so the volume of surgical trauma was minimal. Conclusion. The performed investigation shows the significance of impaired intranasal structures in the development of PRS. Nasal anatomical structural abnormalities, both congenital and acquired, are predisposing factors for the occurrence of rhinosinusitis that may further take its polypous form.