Abstract: Objective To investigate the effectiveness of budesonide combined with clarithromycin in the treatment of chronic rhinosinusitis (CRS) and mucosal tissue remodeling. Methods A total of 162 CRS patients who were admitted into the Second People's Hospital of Chuangshu were enrolled. They were randomly divided into three groups (n=54): a budesonide group, a clarithromycin group and a combination group. The content of eosinophil cationic protein (ECP) in the serum and nasal secretion, the level of serum indicators and inflammatory factors, the Lund -Kennedy endoscopic mucosal morphology scores and sinus CT scores were recorded. Both groups were compared for clinical effectiveness. Results After 15 days of treatment, the content of ECP in the serum and nasal secretion, the Lund -Kennedy endoscopic mucosal morphology scores and sinus CT scores remarkably decreased compared with those before treatment (P＜0.05), and statistical differences were found among the three groups (P＜0.05). Compared with those before treatment, the levels of serum IgE, interleukin-6 (IL – 6), IL - 8 and hypersensitive C-reactive protein (Hs -CRP) were statistical different after 15 days of treatment (P<0.05), and the levels of serum IgE, IL-6, IL - 8, tumor necrosis factor α (TNF-α) and Hs-CRP were statistical different after 30 days of treatment (P<0.05). After treatment, the total effective rate was significantly lower in the budesonide group and the clarithromycin group than that in the combination group (P<0.05). Conclusions The combined use of budesonide and clarithromycin can significantly improve the condition of CRS patients and relieve the remodeling of mucosal tissue.