The polyethology and multifactorial nature of the formation of chronic polypous rhinosinusitis actualize the need for searching additional diagnostic methods and improving therapeutic tactics. The review demonstrates the history of immunohistochemical research methods evolution and analyzes their application in prescriptive predictive analytics and adequate therapeutic tactics in polyposis rhinosinusitis. The revealed indicators of immunohistochemistry in many cases make it possible to take into account the features of the remodeling of the mucous membrane of the nasal cavity and paranasal sinuses, to highlight certain issues of pathogenetic aspects of the disease, to verify the diagnosis correctly, and to improve therapy methods. As an additional method for histological preparations testing, the immunohistochemistry is important in the descriptive specification of clinically important molecular parameters of chronic polyposis rhinosinusitis, in a certain sense, it allows improving therapeutic tactics and predicting the outcome of the disease. © 2025 Elsevier B.V., All rights reserved.