Concha bullosa is hypertrophy of the middle nasal concha attributable to its pneumatisation. It is considered to be the most common anatomical variant of the ostiomeatal complex, but it has been little studied in skeletal populations. It is uncertain whether the prevalence of concha bullosa varies in different world populations. Some have suggested that it predisposes to sinusitis, but this is controversial. The aim of the current work is to assess the prevalence of concha bullosa in a pre-modern population and to investigate whether it is associated with maxillary sinusitis. Results showed that concha bullosa was present in 17 out of 45 individuals, a prevalence of 38%. There was no evidence of an association with sinusitis. This adds to a growing body of evidence that calls into question concha bullosa as a significant risk factor for sinus disease. Copyright © 2012 John Wiley & Sons, Ltd.