Chronic dacryocystitis is a common ophthalmologic disease, with clinical manifestations mainly consisting of tear overflow and purulent discharge from the squeezed lacrimal sac area. The traditional surgical method is the ophthalmologist to reduce the symptoms through extra-nasal nasal lacrimal sac anastomosis, but the success rate is relatively low due to the complicated surgery of the external nasal route, and the postoperative facial scar is often left behind, which affects the aesthetics. Therefore, it is not easy for patients, especially young patients, to accept the treatment of chronic dacryocystitis through the external nasal route. In recent years, with the continuous development of minimally invasive surgery, the surgical treatment of chronic dacryocystitis has been replaced by nasal endoscopic lacrimal sac rhinoplasty. Nasal endoscopic lacrimal sac rhinoplasty is an excellent method for treating chronic lacrimal sacs by otolaryngologic head and neck surgeons and has been increasingly used in clinical practice. The main advantages of nasal lacrimal sac perforation via the nasal cavity are as follows: 1. The treatment of chronic dacryocystitis by nasal endoscopic endonasal approach to the lacrimal sac perforation does not require skin incision and does not leave facial scarring; the medial wall of the lacrimal sac is separated from the middle nasal passage by only a thin bone, so the bone perforation saves effort and time, simplifies the surgical steps and reduces the patient’s pain, so it is easily accepted by patients. 2, nasal endoscopic lacrimal sac nasal perforation, without cutting the muscle and the inner ligament, the damage to the lacrimal sac is small, and does not affect the function of lacrimal conduction of the above-mentioned tissues. The surgery does not need to separate the periosteal lacrimal sac and so on, avoiding the difficulties of surgery caused by adhesions and scars after the last surgery. Postoperative stoma placement of silicone expansion tube can maintain the mucosal stoma and fix the mucosal flap to facilitate wound healing. The majority of chronic dacryocystitis is secondary to the narrowing of the nasolacrimal duct and less from the inflammatory stimulation of the conjunctival sac. Therefore, the success rate of endoscopic endonasal approach for lacrimal sac rhinoplasty for chronic dacryocystitis is high, and the cause of nasolacrimal duct obstruction can be treated at the same time, so that nasal and lacrimal surgery can be completed at one time. In conclusion, transnasal endoscopic treatment of chronic dacryocystitis has the advantages of clear surgical field of vision, small injury, accurate positioning, good postoperative efficacy, especially few complications and no facial scarring. Nasal endoscopic lacrimal sac rhinoplasty has brought a boon to patients with chronic dacryocystitis and is increasingly welcomed by the majority of patients.