Inverted papilloma is noted for recurrence and occasional association with malignancy, leading most authors to recommend lateral rhinotomy as the initial surgical approach in all cases; however, conservative surgery has been reported to be effective in selective cases. Endoscopic control was used in the surgical treatment of three cases of inverted papilloma. In all three cases, the lesions were unilateral and localized, with limited extension into the sinonasal region, and they were not associated with malignancy or recurrent (as proved by endoscopy, computed tomography, and histopathologic examination). Total removal of the mass was achieved through a conservative intranasal approach. Endoscopic follow-up for periods ranging between 12 and 39 months, with an average of 23 months, failed to identify any recurrence. These findings point to the feasibility of applying this conservative endoscopic approach for total excision of limited lesions of inverted papilloma.