The coronavirus disease 2019 (COVID-19) pandemic has heightened awareness of aerosol generation by human expiratory events and their potential role in viral respiratory disease transmission. Concerns over high Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) viral burden of mucosal surfaces has raised questions about the aerosol generating potential and dangers of many otorhinolaryngologic procedures. However, the risks of aerosol generation and associated viral transmission by droplet or airborne routes for many otorhinolaryngology procedures are largely unknown. Indoor aerosol and droplet viral respiratory transmission risk is influenced by four factors: 1) aerosol or droplet properties, 2) indoor airflow, 3) virus-specific factors, and 4) host-specific factors. Here we elaborate on known aerosol versus droplet properties, indoor airflow, and aerosol generating events to provide context for risks of aerosol infectious transmission. We also provide simple but typically effective measures for mitigating the spread and inhalation of viral aerosols in indoor settings. Understanding principles of infectious transmission, aerosol and droplet generation, as well as concepts of indoor airflow, will aide in the integration of new data on SARS-CoV-2 transmission and activities that can generate aerosol to best inform on the need for escalation or de-escalation from current societal and institutional guidelines for protection during aerosol generating procedures. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.