Chronic Rhinosinusitis (CRS) presents a significant clinical challenge, with its persistent nature and resistance to standard treatments affecting millions worldwide. This comprehensive review explores the critical role of bacterial biofilms in the pathogenesis of CRS, shedding light on the sophisticated mechanisms through which biofilms confer resistance to antibiotic therapy and evade host immune responses. By delving into the complex life cycle of biofilms—from initial adhesion and growth to the development of a mature, resistant structure—this article elucidates the underlying reasons for the recalcitrance of CRS. It further examines the current methodologies for biofilm detection and analysis, highlighting their advantages and limitations in advancing our understanding of CRS. The interplay between biofilms and CRS not only necessitates a reevaluation of diagnostic criteria but also opens new avenues for targeted therapeutic strategies. This review underscores the importance of integrating biofilm-targeted approaches into the management of CRS, aiming to disrupt biofilm integrity or prevent its formation altogether. Looking ahead, the article advocates for intensified research efforts to develop and refine biofilm-specific therapies, with the potential to significantly improve patient outcomes and reduce the healthcare burden of CRS. By embracing a biofilm-centric view of CRS pathogenesis, we pave the way for breakthroughs in treatment strategies that could transform patient care and quality of life.