Chronic dacryocystitis is a common disease, the clinical manifestations of which are mainly tear overflow and purulent discharge from the squeezed lacrimal sac area, thus causing much inconvenience to the patient. The traditional surgical method is transnasal external nasal lacrimal sac anastomosis to alleviate the symptoms, but due to the facial scar left after the external nasal surgery, which affects the aesthetics, patients are reluctant to undergo the surgery, especially young patients. With the continuous development of minimally invasive surgery, endonasal endoscopic lacrimal sac rhinoplasty has been increasingly used in clinical practice and has become an excellent surgical method for otolaryngologists to treat chronic lacrimal sacculitis. The main advantages of the procedure are as follows: 1. The medial wall of the lacrimal sac is separated from the middle nasal passage by only a thin bone, so the bone hole can be made with less effort and time, and endoscopic endonasal approach for lacrimal sac rhinostomy for chronic dacryocystitis does not require skin incision, which simplifies the procedure and reduces the patient’s pain and does not affect the aesthetics, so it is easily accepted by patients. 2.Operating under the nasal endoscope, without cutting the muscle and inner contiguous ligament, the damage to the lacrimal sac is small and does not affect the function of lacrimal conduction of the above-mentioned tissues. It is also not necessary to separate the periosteal lacrimal sac, avoiding the difficulty of surgery caused by adhesions and scarring 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 narrowing of the nasolacrimal duct, another factor is from nasal lesions and less from inflammatory stimulation of the conjunctival sac. We are able to treat the etiology of nasolacrimal duct obstruction caused in the nose and achieve satisfactory results by performing nasal and lacrimal surgery in one visit. In conclusion, transnasal endoscopic treatment of chronic dacryocystitis with clear surgical field of vision, less damage, accurate positioning, good postoperative efficacy, especially the advantages of few complications and no facial scarring, has brought a boon to patients with chronic dacryocystitis and is increasingly welcomed by the majority of patients.