PURPOSE OF REVIEW:The autonomic nervous system has been implicated in the pathophysiology of chronic upper airway inflammatory disease for decades. We discuss the most recent literature with regard to autonomic nervous system dysfunction and chronic upper airway disease. RECENT FINDINGS:Recently, state of the art autonomic nervous system testing has demonstrated autonomic nervous system dysfunction in patients with chronic upper airway inflammatory disease. This dysfunction has been characterized as hypoadrenergic. SUMMARY:Autonomic nervous system dysfunction likely plays a role in chronic upper airway inflammatory disease. Further investigation may lead to a better understanding of the role of autonomic nervous system dysfunction in these disorders and, hence, opportunities for novel therapeutic modalities.