The aim of this study was to evaluate whether multislice CT enables quality improvement and dose reduction in the imaging of the paranasal sinuses, especially when using secondary reconstructions. We compared the imaging quality of direct CT scans and secondary reconstructions of single-slice CT (SSCT) as a criterion standard with multislice CT (MSCT) of the paranasal sinuses in 80 patients suspected of having chronic sinusitis. Coronary secondary reconstructions were calculated from all transversal CT data sets. Coronary reconstructions of transversal MSCT showed a significantly better image quality compared with coronary reconstructions of SSCT. Because of the absence of dental metal artifacts, coronary reconstructions of MSCT were superior even to direct coronary images of SSCT. MSCT offered a superior examination quality compared to SSCT. A halving of radiation dosage can be reached by eliminating one examination plane.