We call neonatal dacryocystitis that cannot be treated by lacrimal duct exploration as refractory neonatal dacryocystitis: there are just two reasons: bony nasolacrimal duct malformation and nasolacrimal duct obstruction due to long course of neonatal dacryocystitis, both of which cannot be treated by lacrimal duct exploration to restore lacrimal duct patency, which can be treated by nasolacrimal duct stent implantation and lacrimal sac nasal anastomosis. However, because the nasal cavity of pediatric patients is in the developmental stage, the space is relatively small, and at the same time, the proliferation ability of pediatric patients is strong, the scar is strong after surgery, and the obstruction is easily reoccurred after surgery, so the total treatment effect is not as good as that of adults. For the treatment of refractory neonatal dacryocystitis, we must be cautious and try to use less damaging methods of treatment.