Objective To investigate the value of multislice spiral CT (MSCT) with three-dimensional reconstruction technique in the diagnosis of anatomical structure and variation related disease of ostiomeatal complex. Methods A to-tal of 200 cases of chronic sinusitis patients with normal or variant ostiomeatal complex were retrospectively analyzed with thin layer reconstruction CT images. Results Among these 200 cases, deviation of nasal septum was the majority, accounting for 62.0%. Excessive gasification of ethmoid bulla and middle turbinate gasification were 37.0% and 36.5%respectively . No significant difference was observed between them . The haller cells and uncinate deviation bend accounted for 33.0% and 22.0% separately. Curved middle turbinate accounted for 13.0%. The agger nasi was the least, accounting for 12.5%. Conclusion Three-dimensional reconstruction of MSCT can show the anatomical variations of sinus-nasal as well as the extent of chronic sinusitis clearly, which has important clinical significance on treatment.