DCR is a standard procedure for patients with symptoms of lacrimal outflow impairment. A review of the literature reveals a success rate of 75–99% with EXT-DCR. The success rates of EN-DCR using various technique modifications with or without silicone tubing are in the range of 58–97%. On our study, we concluded 30 patients with epiphora. The aim of this work is to compare the surgical outcomes of endoscopic dacryocystorhinostomy by two different techniques: first by creating large fenestrum rhinostomy, second by creating small fenestrum rhinostomy and to evaluate the necessicity of creating large fenestrum in endoscopic DCR.Results: the long-term surgical results at 6 months in the current study of endoscopic DCR with large and small fenestra are 80% and 46.7% respectively and until further larger studies are done evaluating the size of the rhinostomy created during DCR surgery we recommend endoscopic DCR with large rhinostomy opening with removal of the whole medial wall of the lacrimal sac as the treatment of choice in cases of chronic epiphora due to postsaccal nasolacrimal obstruction.