Epiphora is a common and irritating clinical manifestation of nasolacrimal duct obstruction. Endoscopic dacryocystorhinostomy has become the standard treatment for patients with saccal and postsaccal obstructions of the lacrimal pathway. To prevent the obliteration of the intranasal lacrimal sac ostium, many surgeons prefer to insert silicone tubes to stent the rhinostomy. However, it has been discussed that silicone tubing itself is an inorganic material and therefore may cause formation of intranasal tissue granulation, peripunctal granulation, postoperative infection, canalicular laceration, and punctal adhesions resulting in surgical failure. There is lack of comparative studies of the surgical results of endoscopic dacryocystorhinostomy with and without silicone tubing. Further studies with greater number of patients are needed to evaluate the necessity of silicone tubing in endoscopic dacryocystorhinostomy.