Purpose <p>Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a type 2 inflammatory disease, which can lead to significant impact on quality of life due to symptoms of local and systemic inflammation and has a high recurrence rate despite optimal medical or surgical treatment. Recalcitrant CRSwNP can be treated with biological therapies with specific immunological targets, such as IgE (Omalizumab), IL4α receptors (Dupilumab), or IL-5 (Mepolizumab), which have been approved for this use. The purpose of this narrative review was to review the currently available literature on biological therapies for CRSwNP and their switching in cases of inadequate disease control.</p> Methods <p>Keywords such as ‘biologic’; ‘anti-IgE’; ‘anti-IL5’; ‘anti-IL4’; ‘sinusitis’; ‘chronic rhinosinusitis’; ‘nasal polyps’; ‘switch’; and ‘recurrence’ were combined using the ‘AND’ or ‘OR’ Boolean operators to search databases including Google Scholar, Medline, and EMBASE; free-text search was also utilized for this purpose.</p> Results <p>While there is sufficient evidence to support the use of biological therapies for recurrent and refractory CRSwNP despite the use of nasal corticosteroids as an add-on or adjunctive therapy, there is paucity of evidence regarding switching from one biologic to another. Evidence on biologic switching for recurrent CRSwNP supported the use of Dupilumab while switching from anti-IgE or anti-IL5 biologics, due to better symptom control and improved quality of life outcomes.</p> Conclusion <p>Biological treatments for CRSwNP have good real-life efficacy in managing nasal symptoms and improving quality of life. Multidisciplinary consensus from immunologists or allergists, otorhinolaryngologists, and pulmonologists is essential for aiding decision-making regarding switching biologics.</p>