Chronic Rhinosinusitis (CRS) is a common and frequently encountered disease in the field of otorhinolaryngology-head and neck surgery, characterized by chronic inflammation of the sinonasal mucosa lasting more than 12 weeks. The pathogenesis of CRS is complex, with immune regulation playing a pivotal role. As a critical component of adaptive immunity, CD8?T cells have garnered significant attention in recent years for their heterogeneity and function within the nasal immune microenvironment in CRS. Based on the classification system of distinct CD8?T cells subsets, this review summarizes recent research advances regarding CD8?T cells in CRS. It covers their distribution characteristics across different CRS subtypes, the regulatory effects of the inflammatory microenvironment on their differentiation, the functions of various subsets, and their cytokine secretion profiles. Furthermore, it discusses the potential roles of tissue-resident memory T cells (TRM), stem cell-like memory T cells (TSCM), and granzyme K (GZMK)-mediated complement activation in the immunopathology of CRS. This review aims to provide new perspectives for a deeper understanding of the immune pathogenesis of CRS and to offer potential insights for future precision diagnosis and therapeutic strategies targeting immune cells.