The main symptoms of chronic obstruction of lacrymal pathways are epiphora and chronic dacryocystitis occurring mostly in elderly women. The aim of the surgery is to perform intranasal drainage of the lacrymal sac. The authors performed 30 dacryocystorhinostomies (DCR) in 26 patients with an intranasal endoscopic approach. 24 DCR with a mean follow-up of 25 months and a success rate of 91.7% after one single procedure are discussed. Among three current surgical techniques, the endonasal approach has been shown to be a safe and effective method with many advantages compared to the external transcutaneous way.