Purpose : To evaluate the value of panoramic radiography in diagnosing maxillary sinus inflammation. Materials and Methods : A total of 214 maxillary sinuses from 114 panoramic radiographs were assessed in this study. Two independent experienced oral radiologists evaluated the images in random order for sinus inflammation. Using Cone beam CT images as the gold standard, the sensitivity and specificity of panoramic radiography were calculated, and inter- and intraobserver agreement for panoramic interpretation were obtained. Results : The mean sensitivity and specificity of panoramic radiography were 81.0% and 85.6%, respectively. The weighted kappas for inter- and intraobserver agreement of panoramic radiography were 0.56 and 0.60, respectively. Conclusion : Panoramic radiography is a reasonably accurate method for diagnosing maxillary sinus inflammation and can be used for screening. However, additional examinations should be considered in patients with potentially significant pathology. (Korean J Oral Maxillofac Radiol 2008; 38: 215-8)