Background: Epiphora is defined as watering of the eye due to imperfect drainage of tears through lacrimal passages.It may result from a wide variety of causes, the commonest cause is nasolacrimal duct obstruction (NLDO), which may be congenital or acquired. Acquired NLDO may be primary or secondary.Dacryocystorhinostomy (DCR) is an operation that creates a lacrimal drainage pathway into the nasal cavity to facilitate drainage of the previously obstructed excreting system.Aim of the work: The aim of this study is to compare endoscopic DCR and balloon catheter dilation in treatment of nasolacrimal duct obstruction.Patients and methods; A Prospective randomized comparative Study was conducted on 30 patients .15 cases underwent endoscopic DCR while the other cases underwent balloon catheter dilation. Data were analyzed and compared using Z, Chi-square and Fisher exact test. Results: The balloon catheter dilatation is a safe and minimally invasive technique but the endoscopic DCR has a high success rate.Conclusion:The two techniques are acceptable alternatives. The choice of surgery should depend upon patient's preference and availability of resources.