Mucoceles of the paranasal sinuses are benign cystic lesions characterized by mucous accumulation, which can lead to significant complications due to erosion of sinus walls and compression of adjacent structures. This retrospective study aims to compare the clinical characteristics and treatment outcomes of primary and secondary mucoceles. We reviewed the medical records of 68 patients treated for mucoceles at the Ear, Nose, and Throat Hospital in Ho Chi Minh City, Vietnam, from January 2022 to January 2024. The study highlights the utility of advanced diagnostic imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), in the management of these lesions. Results indicate that primary mucoceles often present with less severe symptoms compared to secondary mucoceles, which occur post-surgery or post-trauma and are associated with more severe symptoms and complications. Treatment primarily involved endoscopic sinus surgery (ESS), with secondary mucoceles frequently requiring more complex surgical interventions. The study underscores the importance of distinguishing between primary and secondary mucoceles for optimizing treatment strategies and improving patient outcomes. Further research is needed to explore long-term treatment effects and the efficacy of different surgical approaches.