We report six cases (three males and three females aged 5 to 85 years) with paranasal sinusitis and orbital complications seen at Mie University Hospital in the last 10 years. Based on the classification of Chandler et al, one case belonged to stage II (orbital cellulitis), three to stage III (subperiosteal abscess), and two to stage V (cavernous sinus thrombosis). All six patients decreased visual acuity and four had ophthalmoplegia. Except for one complicated by meningoencephalitis, five recovered from decreased visual acuity. Streptococcus species were isolated from three. Aspergillus and Propionibacterium were detected from a case who died of meningoencephalitis. A five-year-old boy was treated by antibiotic administration alone and either endonasal sinus surgery or an external approach was conducted in five.