Aim: This study aimed to analyze the anatomical variations of the paranasal sinuses using computed tomography (CT) imaging, focusing on their prevalence, patterns, and clinical implications. Material and Methods: A cross-sectional observational study was conducted on 80 participants aged 18–65 years at the Departments of Anatomy and Radiodiagnosis, Government Medical College Anantnag, J&K. CT scans were performed with a multi-slice scanner, and axial, coronal, and sagittal sections were obtained with a slice thickness of 0.5–1 mm. Anatomical variations such as concha bullosa, deviated nasal septum, Haller cells, Onodi cells, Agger Nasi cells, and sinus pneumatization variations were analyzed. Data were statistically evaluated to assess the prevalence and association of these variations with demographic factors like age and sex. Results: The study revealed a high prevalence of anatomical variations, with Deviated Nasal Septum (52.50%) and Concha Bullosa (45.00%) being the most common. Ethmoidal sinus variations were the most frequent among individual sinuses (40.00%), followed by frontal (25.00%), sphenoidal (22.50%), and maxillary (12.50%) sinus variations. Significant associations were found between demographic factors and variations, with males showing higher prevalence rates for Concha Bullosa (59.57%) and Deviated Nasal Septum (63.83%). Participants aged 31–50 years exhibited the highest prevalence of Deviated Nasal Septum (55.56%), while younger participants had a higher prevalence of Concha Bullosa (45.45%). Conclusion: This study highlights the high prevalence and clinical significance of anatomical variations in the paranasal sinuses. These findings underscore the importance of CT imaging in diagnosing sinonasal conditions and preoperative planning for functional endoscopic sinus surgery to reduce complications and improve outcomes.