A randomized comparison of the usual surgical removal of nasal polyps versus systemic steroid treatment was performed in 53 patients. In all, continuous topical steroid treatment was given during the one year period of observation. In both groups the initial treatment resulted in a continuous increase in mean nasal expiratory peak flow as well as in the sense of smell; these two parameters showed a temporary statistically significant difference in favour of the medically treated group. In general though, the results in the two treatment groups were alike. Therefore medical treatment is recommended for routine use. Surgical removal should be reserved for those few cases in which the presence of residual or recurrent polyps justifies the inherent risks and discomfort for the patient.