Management algorithms for frontal sinus fractures vary widely. Appropriate treatment depends on an accurate diagnosis, focusing on the physical examination and data from computed tomography scans. One must pay particular attention to involvement of the nasofrontal duct and violation of the posterior table because it is from these injuries that so much of the morbidity relating to these fractures is incurred. In large part, in the most severe injuries, a successful outcome is contingent upon meticulous removal of all visible frontal sinus mucosa with occlusion of the nasofrontal duct if required.