Objectives The COVID‐19 pandemic affected the epidemiology of several diseases. This study aims to compare the incidence of surgically treated odontogenic sinusitis (ODS) before and during the COVID‐19 pandemic and identify unique features. Methods A retrospective chart review of patients who underwent at least maxillary antrostomy at a tertiary referral center was performed. The patients were divided into two cohorts: “pre‐COVID” (March 2018 to February 2020) and “COVID” (March 2020 to February 2022). Data on demographics, comorbidities, and treatment interventions were collected and analyzed. Results Of the 734 patients who underwent maxillary antrostomy, 370 (50.4%) were operated on during the COVID period, with a mean age of 53.1 ± 15.7 years. ODS was found as the etiology of 22 (6%) and 45 (12.2%) of the pre‐COVID and COVID cases, respectively (p = 0.006). Although no difference was found in the incidence of diabetes (p = 0.9) or obesity (p = 0.7) between groups, a trend toward higher incidence of immunosuppression was found in the pre‐COVID patients (18.2% vs. 0%, p = 0.06). A higher incidence of sphenoid sinus involvement (31.8% vs. 8.9%, p < 0.05) was identified in the pre‐COVID group; however, no differences in ethmoid (86.4% vs. 86.7%, p = 0.999) or frontal sinus involvement (54.5% vs. 37.8%, p = 0.3) were found between the groups. Conclusion There was an increase in the incidence of ODS during the first 2 years of the COVID‐19 pandemic compared to the 2 years prior. Similar clinical characteristics were found in both groups. Future studies focusing on specific etiologies to explain ODS preponderance may help determine optimal treatment and prevention strategies. Level of Evidence 3 Laryngoscope, 134:1597–1602, 2024 In this study of 734 patients undergoing maxillary antrostomy at a single institution, odontogenic sinusitis (ODS) incidence was found to rise sharply after the onset of the pandemic. Additionally, the presentation of ODS during the COVID‐19 pandemic was found to be more advanced.