Conclusion: The mucosa compliance in lesions is determined by the congestion index, enabling us to determine whether the patient is sensitive to pharmacotherapy and to choose surgical management rationally. Objective: To explore the correlation between the nasal mucosa congestion index and tissue remodeling in chronic rhinosinusitis (CRS) and to provide objective evidence for clinical choice of therapeutic methods. Patients and methods: Forty-four patients with CRS who underwent nasal endoscopic surgery were enrolled in the study. The congestion indexes of the nasal mucosa were measured using an acoustic rhinometer and specimens were taken from the uncinate process mucosa to evaluate vascular density and degree of fibrosis. The correlations were statistically analyzed. Results: There was an inverse correlation between the congestion index and degree of fibrosis (r = -0.522, p = 0.00) and a direct correlation between the congestion index and vascular density (r = 0.838, p = 0.00) in nasal mucosa. There was a significant correlation between the congestion index and the combination of degree of fibrosis and vascular density with a determination coefficient (R-2) of 0.778.