AbstractAims and Objectives: The present study was conducted to compare the success rate of external and endonasal endoscopic dacryocxystorhinostomy (DCR) for acquired nasolacrimal duct (NLD) obstruction. Material and Methods: It was a prospective study performed in the department of Ophthalmology and department of otorhinoloaryngology at Ananta Institute of Medical Sciences, Rajsamand, Rajasthan during the period of 4 years from February 2016 to February 2020. A total of 120 patients with the clinical diagnosis of chronic dacryocystitis and nasolocrimal duct obstruction were included in the study. 40 patients underwent external DCR and 80 patients underwent endonasal DCR. Results: Total 120 patients were included in the study out of which 104 (86.66%) were female and 16 (13.33%) were male. The age of the patients ranges from 20 years to 70 years with the mean age of 52.5 years. Postoperative anatomical patency of NLD was achieved in 95% in external DCR group and 93.75% in Endonasal DCR group. Long term anatomical patency of NLD and symptom relief (assessed 6 months after surgery) was achieved in 87.5% patients in external DCR group and 86.25% patients in endonasal DCR group. The total incidence of complications in external and endonasal DCR group was 12.5% and 10% respectively. Conclusion: Dacryocystorhinostomy (DCR) is the treatment of choice for nasolacrimal duct obstruction and can be done by external or endonasal endoscopic approach. Both the procedures have similar results with minimal complications. Keywords: chronic dacryocystitis; Nasolacrimal duct; Endonasal, Lacrimal sac; Dacryocystorhinostomy.