Fungal rhino sinusitis (FRS) is recognised in persons of all age groups resulting in great socioeconomic effects including both direct and indirect costs to the society. It has significant impact on quality of life in comparison to chronic debilitating diseases like diabetes mellitus and congestive cardiac failure. Rapid increase in fungal infections is noticed now a days due to increased use of immunosuppressive agents, prolonged use of broad spectrum antibiotics, radiotherapy and chemotherapy. Newer antifungal drugs are being marked recently besides so many drugs are already available.  Drug resistance has been reported for certain antifungal drugs also. Hence in vitro susceptibility testing of the isolate is mandatory for the selection of appropriate antifungal drug to treat the patient with FRS. If the appropriate antifungal agent is administered at the appropriate time, complications can be avoided. A study was conducted in the Dept. of Microbiology Govt. Medical College, Thiruvananthapuram, Kerala for a period of one year from August 2015 to July 2016 to identify the fungal pathogens causing FRS in patients attending the ENT dept.  A total number of 186 clinically diagnosed cases of FRS from whom different types of clinical specimens were collected and processed in the 24 hours clinical Microbiology Laboratory attached the Govt. Medical College Hospital, TVM. A total number of 50 isolates were obtained by fungal culture. The culture positivity was 26.88%. Aspergillus species were the predominant isolates (62%). Among them, Aspergillus fumigatus was the most common isolate (42%) followed by A.flavus A, niger (19.35%) and A terreus (6.45%). Antifungal susceptibility testing of the Aspergillus isolates were done by microbroth dilution method according to CLSI (2008) guidelines M38–A2. The isolates showed 100% sensitivity to Itraconazole and 93.5% sensitivity to Amphotericin B. All of them were resistant to Fluconazole (100%). The mortality rate in the study significantly reduced (4%) due to early detection and  initiation of appropriate antifungal therapy.