Abstract Introduction Chronic rhinosinusitis (CRS) is phenotypically classified into Chronic rhinosinusitis with or without nasal polyposis, CRSwNP and CRSsNP, respectively. Many treatment modalities exist for CRSwNP such as corticosteroids, among others. Despite the advancements in medical management, surgical procedures such as Endoscopic Sinus Surgery (ESS) are still required, especially for cases where medical managements alone is not sufficient. This study aims to evaluate the efficacy of different postoperative medical regimens given after functional endoscopic sinus surgery. Methods 144 patients who underwent Functional Endoscopic Sinus Surgery (FESS) in 4 different clinics and had CRSwNP were recruited. All patients underwent clinical, laboratory and radiological tests. Patients were grouped into 5 groups based on presence of eosinophilia, AERD, chances of recurrence, and clinical/radiological severity. The aggressiveness of the treatment increases as you go up the groups, with group 1 receiving the least aggressive treatment. Results In this prospective cohort study, most of the patients were female (52.1%) and their ages ranged from 21-73 years old, with a mean of 37.4±10.7 years old. The recurrence rate after 2 years following surgery increases from 0% in Group 1, to 33.3% in Group 5. Conclusion Many strategies can be pursued to decrease the recurrence of CRSwNP following ESS. These include extensive preoperative patient preparation, delicate removal of all cells during endoscopic sinus surgery and a postoperative medical regimen tailored to the severity of the disease that requires complete adherence. Furthermore, it is essential to consider all hidden anatomical spaces during ESS.