Intraorbital wall fractures are common simple burst fractures, which are caused by striking the weakest part of the orbital wall with an object larger in diameter than the orbital orifice or the orbital rim and herniation of the intraorbital soft tissue into the sinus by Kanton. Because the septal cardboard of the orbital wall is the weakest, experimental studies have found that septal cardboard fractures are the most common, followed by fractures of the inferior wall. Our clinical experience has shown that fractures of the orbital wall are also the most common, but previous reports have shown the highest incidence of fractures of the orbital floor, followed by the inferior and then the medial orbital wall, which may be related to the sample and ethnicity. The current surgical approaches for intraorbital wall fractures are the skin incision (lower lid submandibular, medial canthotomy, and Lynch incision); the conjunctival incision and the sinus transseptal approach and, rarely, the reported coronal incision approach. The transcutaneous medial canthotomy may require dissection of the medial canthal ligament, leaving postoperative facial scarring and tear duct injury. The lower lid conjunctival fornix approach or the lower lid submasculature approach is difficult to expose the fracture zone, especially the superior fracture margin. The lacrimal fossa approach, which has recently gained popularity, allows for a smooth dissection at the natural level behind the Horner muscle, avoiding the lacrimal system and the medial canthal ligament, through a posterior lacrimal fossa incision (avoiding a skin incision). However, intraoperative exposure is difficult due to the small operating space, the difficulty of complete repositioning of the herniated tissue in the orbit and the difficulty of implant placement. Patients with larger fractures, especially those with the posterior edge of the fracture close to the optic nerve, are highly susceptible to damage to the optic nerve due to the small field of view. The endoscopic technique was first used by otolaryngologists for orbital fracture surgery, and the general transseptal pathway was used to fully expose the fracture area, but it was difficult to implant the repair material. Our creative combination of endoscopic technique and transconjunctival pathway surgery solved the above problems, and the related article has been published in the journal “Ophthalmology”. The technical points of the endoscopic fracture repair surgery through the lacrimal fossa include: ① Skilled use of the endoscope, because of the small space, it is very easy to contaminate the lens with blood and body fluid during the operation, which makes the operation difficult. ② Confirmation of special anatomical landmarks especially endoscopic anatomical landmarks including surface anatomical landmarks of the semilunar folds, deep anatomical landmarks including posterior lacrimal ridge, anterior sieve foramen, posterior sieve foramen and optic nerve foramen, infraorbital fissure, etc. Especially for the optic foramen and infraorbital fissure, because the endoscopic monitor image loses the position reference of the surrounding anatomical structures and the image has no sense of direction, it is very easy to mistake the optic foramen and the tissue in the infraorbital fissure for Kanton’s tissue and separate them, and then the corresponding complications occur. If the fracture is large and involves the inferior orbital wall, the inferior oblique muscle and the lcokwood ligament should be separated and protected when the incision needs to be enlarged downward. ③Gentle and precise surgical movements. Pay attention to avoid damaging the lacrimal duct, lacrimal sac, and orbital periosteum when making the incision to avoid intraorbital fat from entering the operative field. Carefully identify the sinus and orbital tissues during separation to avoid implantable cysts. Because of the complete separation of the fracture margin and the complete retraction of the intraorbital tissues, a thinner and more malleable material can be chosen for the artificial bone. Due to the small incision, care should be taken to protect the upper and lower lacrimal ducts during implantation; Lee et al. suggested leaving part of the fracture area at the posterior orbital rim to avoid damage to the optic nerve, but we believe that the unretracted intraorbital tissue may shift the position of the implant with the movement of the eye and complications may occur. No damage to the optic nerve occurred during any of our endoscopically monitored artificial bone implantations. The choice of materials for orbital wall fracture repair, orbital wall support such as silicone and balloon used in ENT is insufficient and incomplete orbital wall repositioning occurs. Medpor and hydroxyapatite, which are both hard and vascularizable, should be the materials of choice for medial wall fractures. Previous surgical pointers were more concerned with the functional condition of the patient (e.g., inversion or displacement of the eye greater than 3 mm, diplopia, and extraocular muscle motility disorders), and with advances in surgical techniques, we should strive to restore the patient’s anatomy with functional recovery.