Inverted Schneiderian Papilloma remains a controversial nasal disease. Although a benign pathology it is associated with aggressive local destruction, recurrence after removal and malignancy. New information regarding aetiology may aid management which at present consists of surgical resection. The best method of resection is still undetermined. This paper describes 43 cases of Inverted Schneiderian Papilloma presenting to a tertiary referral centre and discusses the present knowledge surrounding the pathology and its treatment.