Objective To explore the clinical effect of budesonide nasal spray combined with Biyuan Tongqiao granule in children with chronic sinusitis. Methods A total of 100 children with chronic sinusitis admitted to Heze Caozhou Hospital from January to December 2022 were selected and divided into control group and study group according to random number table method, with 50 children in each group. The control group was treated with budesonide nasal spray. The study group was treated with Biyuan Tongqiao granules on the basis of the control group. The therapeutic effects, clinical symptoms and adverse reactions were compared between the two groups. Results The effective rate of treatment in the study group was higher than that in the control group, and the difference was statistically significant (P <0.05). The clinical symptom score of the study group was lower than that of the control group, and the difference was statistically significant (P <0.05). The incidence of adverse reactions in the study group was lower than that in the control group, and the difference was statistically significant (P <0.05). Conclusion For children with chronic sinusitis, budesonide nasal spray combined with Biyuan Tongqiao granules can effectively reduce the inflammatory response and promote the repair of nasal mucosa in children. It has high clinical efficacy and is worthy of clinical application.