Aim: To evaluate the clinical spectrum, radiological findings, treatment modalities, and outcomes of fungal diseases of the nose and paranasal sinuses in patients treated at a tertiary care hospital. Materials and Methods: This prospective observational study included 120 patients diagnosed with fungal diseases of the nose and paranasal sinuses over a 12-month period. Detailed clinical evaluations, radiological imaging (HRCT and MRI), and microbiological and histopathological analyses were conducted. Patients received medical therapy, surgical intervention, or a combination of both, depending on disease severity. Data were analyzed using SPSS version 20.0, with statistical significance set at p < 0.05. Results: The study population had a mean age distributed across three groups, with the 31–50 age group (46.67%) being most affected. Males (56.67%) were more frequently diagnosed than females (43.33%). Allergic fungal rhinosinusitis was the most common subtype (53.33%), followed by chronic invasive fungal sinusitis (23.33%), acute invasive fungal sinusitis (13.33%), and fungal ball (10%). Radiological findings showed maxillary sinus involvement in 65% of cases, with bony erosion in 38.33%. Treatment primarily involved functional endoscopic sinus surgery (76.67%) and antifungal therapy, with amphotericin B being the most commonly used agent. Complete symptom resolution was achieved in 81.67% of patients, while complications such as orbital involvement (11.67%) and antifungal toxicity (8.33%) were observed in a minority of cases. Conclusion: Fungal diseases of the nose and paranasal sinuses, particularly allergic fungal rhinosinusitis, represent a significant clinical challenge. Early diagnosis through imaging and microbiological confirmation, coupled with tailored medical and surgical interventions, is critical for favorable outcomes. Public health measures to improve awareness and address underlying risk factors, such as diabetes and immunosuppression, are essential for reducing the burden of these diseases.