Dysosmia, or the distortion of olfaction, is most commonly preceded by viral illness or head trauma, but has a variety of etiologies. The precise nature of the disease process remains obscure. Medical management is largely empiric, and has been aimed at treating underlying illnesses, restricting triggering medications, as well as various pharmacologic interventions. Successful eradication of a severe case of persistent unilateral paroxysmal dysosmia with resection of the ipsilateral olfactory bulb has been reported. We report here a case of bilateral paroxysmal dysosmia, refractory to medical therapy, successfully treated with bilateral olfactory bulb resection. © 1993.