Orbital complications of sinusitis have declined in the postantibiotic era. Nonetheless, the development of a subperiosteal or intraorbital abscess remains a serious condition that is best managed through a multidisciplinary approach. Surgical management is almost always indicated when orbital collections are present, and medical therapy plays a complimentary role. The endoscopic approach of draining a medial orbital collection offers significant advantages over the traditional external approach. The preoperative and intraoperative use of computer-aided technology may be a useful adjunct in the endoscopic management of orbital abscesses.