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INTRODUCTION: Paranasal sinus fungal ball (FB) usually affects middle aged and elderly females, who are not immunocompromised. It is commonly due to aspergillus species. The most frequently involved sinus is the maxillary sinus followed by sphenoid sinus. CT paranasal sinus( PNS) is the imaging of choice and histopathology confirms the diagnosis. Endoscopic sinus surgery is the mainstay of treatment for sphenoid sinus fungal ball (SSFB). MATERIAL AND METHODS: A retrospective study was carried out in the department of ENT at Santosh Medical College and Hospital, Ghaziabad. A total of 4 patients with SSFB were studied from April 2022 to September 2022 Diagnostic imaging followed by definitive Endonasal endoscopic sphenoidotomy(EES) was carried out. The aim of the study is to highlight various clinical presentations of SSFB and significance of early management in these cases. RESULTS: All the 4 patients were females with age ranging from 47 to 62 years. There was unilateral SSFB in all cases, as assessed by CT PNS. Endonasal endoscopic sphenoidotomy(EES) ensured complete debridement of FB and optimal sinus ventilation and drainage. CONCLUSION: Patients with SSFB may present with non-specific symptoms or be asymptomatic. Therefore high index of suspicion has to be kept to avoid delay in the diagnosis. CT PNS confirms the diagnosis. EES is the standard treatment modality for complete disease extirpation with no morbidities.