Aspirin intolerance (AI) or aspirin sensitivity is a side effect of normal doses of aspirin ingested by humans. In 1968, American immunologists Samter and Beers completely described the intrinsic connection between aspirin intolerance, bronchial asthma, and nasal polyps, and officially named it the aspirin triad (Samter’s triad). triad), also known as acetylsalicylic acid triad (ASA triad), Widal’s triad, or Francis’ triad. Recently, Chronic hyperplasticeosinophilic sinusitis (CHES) has been categorized as the fourth hallmark of the disease and the series of syndromes is collectively referred to as Aspirin-exacerbated respiratory disease (AERD). Patients with the aspirin triad often present to ENT with complaints of nasal congestion and decreased/loss of sense of smell. In addition, nasal polyps caused by aspirin intolerance are often more symptomatic (e.g., extensive polypoid changes in the mucosa, combined with asthma, etc.), making treatment more difficult. We would like to share the treatment of a typical case with you: History: Male, 46 years old. 10 years after nasal endoscopy, 3 years of nasal congestion and pus. Intermittent bilateral nasal congestion with pus and paroxysmal sneezing, loss of smell and irregular headache. Symptoms improved after taking prednisolone and antihistamines. Past history: 20 years history of bronchial asthma Surgical history: nasal polyp removal in 1994, nasal endoscopic nasal polyp removal and sinus opening surgery in 2002 Drug allergy history: bronchial asthma attacks can be triggered by taking aspirin. Physical examination: nasal septum was centered. Bilateral nasal cavity with numerous translucent polyp-like neoplasms. The olfactory fissure is the most important area. Note: Bilateral polyps in the olfactory fissure of the nasal cavity. So loss of smell. Sinus CT: Note: Obstructive manifestation of the whole group of sinuses with soft tissue shadow of middle nasal tract and olfactory fissure. Smear of nasal secretions and pathological section of polyps: full field of eosinophils ++++. Surgery: 2 and a half hours long nasal endoscopic surgery. (Because a bilateral DrafII frontal sinus opening was done, slowly grinding away the bone, very time consuming and tiring) Note: 1 year after surgery, smooth and epithelialized cavity. The symptoms disappeared. Summary: Preoperatively: treatment with hormone (oral + transnasal nebulized inhalation) was effective in improving symptoms reducing intraoperative bleeding and operative time. Surgery: excision of middle turbinate and enlarged opening of bilateral frontal sinuses. For middle turbinates with existing structural remodeling and polypoid lesions, excision helps to remove the lesions and improve the symptoms, especially the sense of smell. Postoperatively: sequential use of hormones (oral + transnasal nebulized inhalation) oral montelukast sodium. Finally and most importantly: for such recurrent nasal polyps with asthma, surgery is only the first step in a long march. Standardized medication, stable and continuous postoperative follow-up, and timely detection and management of problems during the follow-up are the norm for future treatment.