Key Points Inverted papillomata are benign sinonasal tumours with high recurrence rates. Inverted papillomata recurrence is increased if operated on by a non-fellowship trained rhinologist. Inverted papillomata recurrence can be detected earlier in cases managed by specialist rhinology services. Inverted papillomata should be managed through a clear treatment pathway for sinonasal tumours. Other risk factors associated with increased recurrence include Krouse stage 3 and involvement of the frontal or maxillary sinuses.