The objective of this study is to evaluate effectiveness of hypertonic nasal saline irrigation and Anuloma viloma exercise for improving severity, frequency of sinus symptoms and quality of life in chronic rhinosinusitis with patients taking only maximal medical therapy. In this prospective clinical study, 56 patients with chronic rhinosinusitis were enrolled and divided into 3 groups according to treatment given with group1 (MMT– maximal medical therapy), group 2 (MMT with hypertonic nasal saline irrigation) and group 3 (MMT with Anuloma viloma exercise). Patients were evaluated before treatment and at 3 and 6 months after treatment as per symptoms score (VAS, SNOT–20, GQ, RSDI) and sign scoring (CT scan and nasal endoscopy).Maximum improvement in symptom score was 54.43%, 72.42% and 67.69% in group1 , 2 and 3 respectively that occurred after 3months, then improvement were 76.49%, 86.25% and 84.5% in group 1 , 2 and 3 respectively at 6months. Maximum improvement in sign score was 49.93%, 63.16 % and 53.81 % in group 1, 2 and 3 respectively that occurred after 3months, then improvement were 81.11%, 90.95 % and 84.61% in group 1 , 2 and 3 respectively at 6months.MMT with Anuloma viloma exercises improves quality of life in CRS. Our study recommends a combination of both MMT and hypertonic saline irrigation with anuloma viloma exercises at improving the symptom severity, symptom frequency, sign scores and quality of life in patients of CRS.