Tears drain from the eyes into the nose. When there is a block in this drainage pathway, tears well up in the lacrimal sac and resulting in infection (Dacryocystitis).  To relieve obstruction, alternative drainage has to be made between the lacrimal sac and nose (Dacryocystorhinostomy-DCR).  It can be done through the nose endoscopically (endo DCR) or via an incision in the skin of the face (external DCR). Endo DCR has many advantages over external DCR.  It is cosmetically better as there is no scar. Post-operative morbidity is minimal for endo DCR Physiologically it does not interfere with the lacrimal pump system. We have one of the largest series of endo DCRs in Kerala with more than 300 cases.