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AIM:To explore the outcome and safety of endonasal dacryocystorhinostomy(EN-DCR)with the use of adjunctive mitomycin C(MMC)in nasolacrimal duct obstruction or within dacryocystitis or lacrimal sac abscess. <p>METHODS: Select the 32 cases(38 eyes), noses and lacrimal duct obstruction(or with dacryocystitis, lacrimal sac abscess)in patients with endoscopic nasal bone hole made at the mound, removal of the nasal mucosa, lacrimal bone and a fragment of frontal process of maxilla. cut the lacrimal sac and fully flip flap, 0.1g/L MMC retained tampon in lacrimal anastomotic removed after 48 hours.<p>RESULTS: Postoperative 7 days, 3 and 6 months nasal endoscopy and lacrimal irrigation. Postoperative 7 days, healing 34 eyes, improved in 3 eyes, ineffective 1 eye, treatment improvement rate was 97.4%; postoperative 3 months, cured 32 eyes, improved in 4 eyes, invalid 2 eyes, healing rate was 94.7%; postoperative 6 months, cured 32 eyes, improved in 4 eyes, invalid 2 eyes, treatment improvement rate was 94.7%. All cases did not occur nasal bleeding, orbital complications and postoperative complications.<p>CONCLUSION: Results suggest that EN-DCR with MMC is a safe and successful procedure for the treatment of nasolacrimal duct obstruction or within dacryocystitis or lacrimal sac abscess.