Frontal sinus fractures represent approximately 10-15% of maxillofacial fractures and are generally a result of high-speed motor vehicle accidents, assaults, or sporting injuries1. Historic treatment options have included: observation, open reduction and internal fixation, obliteration, and cranialization. Frontal sinus fractures often occur with involvement of the frontal sinus outflow tract (FSOT) which has been treated aggressively to prevent complications including CSF leak, sinusitis, mucocele, meningitis, or brain abscess. To avoid the possibility of these complications, immediate surgical treatment of FSOT fractures has been a standard practice. However, early surgical intervention has an intrinsic morbidity, and through technologic and endoscopic advances, conservative management (i.e. observation) of FSOT fractures has become more common as well as a more viable option to treat the described long-term complications.