【Abstract】 Objective To observe and compare the efficacy of endonasal dacryocystorhinostomy (external DCR) and externaldacryocystorhinostomy (endonasal DCR) for the treatment of recurrent dacryocystitis. Methods From December 2013 to December 2017, 75 patients with recurrent dacryocystitis who received endonasal DCR versus external DCR treatment in Department of Otolaryngology and head surgery, West China Hospital of Sichuan University, were retrospectively analyzed. There were 24 cases in endonasal DCR group and 51 cases in external DCR group. 20 patients in each group were evaluated for hospitalization expenses, intraoperative blood loss, operation duration and tear discharge score. Results Significant differences were observed in hospital costs (median, 9264.3 vs. 4703.2 RMB, P＜0.001). There was no significant difference of the duration of surgery (median,60.0 vs.45.0 minutes, P=0.057) or the volume of intraoperative hemorrhage (median, 55.0 vs. 40.0 mL, P＜0.436). There was no significant difference of epiphora score between endonasal DCR and external DCR in 3 months (median,1.0vs.1.0, P=0.944), 6 months (median,1.0vs.1.0, P=0.918) but showed significant difference at 12 months (median,1.0 vs.2.0, P=0.041). Conclusion endonasal DCR was shown better results in relieving epiphora in patients with recurrent dacryocystitis when compared with external DCR and may be a priority method for the dacryocystitis.