Purpose: To evaluate the outcome and patterns of failure in patients with Non-Hodgkin's Lymphoma of the nasal cavity and paranasal sinuses treated either by radiation alone or combined radiation and surgery or radiation and chemotherapy.Materials & Methods: Forty-Four patients with sinonasal lymphoma (Ann Arbor Stage IE-IIE) were treated by radiation alone or in combination with surgery and/or chemotherapy at our institution. Thirty-three patients were stage I (75%), and nine (20%) were stage II. Two patients were not able to be staged. Thirty-five patients were treated with radiation therapy alone, 4 patients received combination chemotherapy and radiation, and 5 patients received postoperative treatment with radiation.Results: The actuarial survival for the whole group at five years was seventy-three percent. The corresponding results for Stage I and Stage II were seventy percent and one hundred percent. The 5-year actuarial disease-specific survival was seventy-two percent for Stage I and one hundred percent for Stage II. The local control at 5 years was ninety-five percent for Stage I and one hundred percent for Stage II. Distant failure for the entire group occurred in 1244 (27%) patients. For patients treated with radiation alone, local failure occurred in 335 (9%) patients while distant failure occurred in 935 (28%) patients. Of those receiving combination chemotherapy and radiotherapy, 04 failed locally and 14 failed distantly. For those patients treated with surgery and radiation 05 failed locally and 25 failed distantly. Both local and distant failure occurred in 1344 patients for the entire group with 1035 for radiation alone and 14 for chemotherapy combined with radiation and 25 for surgery and radiation.Conclusion: Non-Hodgkin's Lymphoma involving the sinonasal regions of the Head and Neck is a rare tumor. Local control of this disease by radiation therapy alone is excellent. However distant failure remains a problem because most die from distant disease rather than local disease. We would therefore recommend adjuvant chemotherapy after primary radiotherapy to help control for distant disease and hopefully translate into an increase in overall survival in these patients.