While external and endoscopic dacryocystorhinostomy (DCR) remain the gold standard for nasolacrimal duct obstruction, today we live in a surgical era that strives towards minimally invasive surgery. Natural orifice transluminal endoscopic surgery (NOTES) is an emerging field within other disciplines. Lacrimal surgery has seen this trend with the introduction of the microendoscope. Endoscopic lacrimal duct recanalization (ELDR) provides an alternative approach to the treatment of obstructive epiphora. ELDR is currently the least invasive procedure designed for primary acquired nasolacrimal duct obstruction (pando). It is appealing as it restores integrity of natural lacrimal drainage system, and avoids the necessity of making new bony openings.