Background: The treatment of orbital floor fractures remains a controversy and there is no widely accepted consensus regarding indications and surgical technique. Reduction of orbital tissue via a transcutaneous approach can be very difficult and lead to unsatisfying results. Aim of the work: It aims at exploring the feasibility and efficiency of endoscopic transantral reduction of isolated orbital floor fractures versus the open reduction techniques. Patients and methods: A prospective study submitted on 30 patients. Only isolated orbital wall fractures included(pure blowout fractures), pre-/postoperative ophthalmological/orthoptic follow-up, pre-operative CT. Variables recorded were patient age and gender, etiology of injury, time to surgery, follow-up period, surgical morbidity, diplopia pre- and post-operatively (Hess test), and the presence of en-/or exophthalmos (Hertel exophthalmometer). Half patients (15) had done open traditional methods and the other half had done endoscopic trans antral reduction techniques. Conclusions: Reconstruction of isolated orbital floor fractures via endoscopic approach appears to be safe and effective. A significantly better outcome, regarding enophthalmos and diplopia improvement, was found. Endoscopic reconstruction of orbital floor fractures seems to be a more accurate and successful treatment.