Inverted papilloma is a relatively rare epithelial neoplasm of the nose and paranasal sinuses accounting for 0.5-4% of all primary tumours of the nose. This is a retrospective study of fifteen patients with histologically confirmed I.P. of the nose and paranasal sinuses seen from 1986 to 2000 at the Department of Otorhinolaryngology, University College Hospital, Ibadan. The patients ages range from 14-65 years, with a median age of 39 years. There were twelve males and three females. Five patients had advanced lesions of which four were bilateral. There was associated synchronous and metachronous squamous cell carcinoma (SCC) in two patients respectively. The surgery offered was based on the clinical and radiological evaluations of these patients. Nine patients had conservative surgery (intranasal clearance/antrostomy and external fronto-ethmoidectomy) while the remaining six patients had radical surgery (lateral rhinotomy/medial maxillectomy) at various times. The two patients with SCC had adjunct radiotherapy/chemotherapy in addition. Recurrence was observed in those that had conservative surgery only. We therefore advocate radical surgery in our environment as the treatment of choice for effective limitation of recurrence.