Bacterial biofilms are three-dimensional aggregates of bacteria encased in secreted exopolysaccharides (slime) and lack vulnerability to antibiotics that planktonic bacteria demonstrate. Biofilm-forming bacteria are common. Bacterial biofilms may contribute to medically recalcitrant chronic rhinosinusitis (CRS). Tactics developed to treat planktonic bacteria are ineffective against bacteria in a biofilm - this helps explain a portion of the persistent and recurrent infections observed in CRS. Understanding how biofilm infections form is fundamental to developing rational strategies for the prevention and treatment of biofilm-associated CRS. New investigations into therapeutic remedies aimed at eradicating biofilm infections are ongoing and hold promise for alleviating individuals' suffering from recurrent infections associated with CRS. © 2010 Springer-Verlag Berlin Heidelberg.