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Background: Nasal irrigation with corticosteroids is a well-established adjunctive therapy following endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyps (CRSwNP). However, the optimal irrigation volume remains uncertain. Large volumes (e.g 240mL) may improve sinonasal distribution, but could also increase discomfort, adverse effects, or unnecessary costs. This study aimed to compare the clinical efficacy and tolerability of two irrigation volumes—120 mL vs. 240 mL—of budesonide nasal irrigation following ESS in patients with CRSwNP. Methods: This prospective, randomized, blinded trial included forty-four patients with CRSwNP following ESS in the first 60 days postoperative. Patients were randomized (1:1) to receive nasal irrigation containing saline plus budesonide (1mg/240mL), with either 120mL or 240mL twice a day. The Sino-Nasal Outcome Test-22 (SNOT‑22) and Lund‑Kennedy endoscopic score (LKS) were assessed preoperatively and at 30 and 60 days postoperatively. A questionnaire was used to record adverse events at postoperative visits. Results: Forty‑two patients (aged 18–70 years, mean (SD): 50.6 (12.8); 21 per group) completed the trial. Both irrigation volumes significantly reduced SNOT-22 and LKS scores, with no significant differences between groups at any time point. Cough was more frequent in the 240 mL group at day 30, but this difference was not significant at day 60. Conclusions: Budesonide irrigation with 120 mL or 240 mL was equally effective in the early postoperative period in improving symptoms and endoscopic findings. Higher-volume irrigation may cause more transient early adverse effects but appears well tolerated by day 60. Both regimens may be suitable for postoperative management of CRSwNP.