External dacryocystorhinostomy (DCR) surgery is a widely employed procedure in ophthalmology for the treatment of nasolacrimal duct obstruction (NLDO). This surgical intervention involves modifying the nasal anatomy to restore the normal drainage of tears. Two primary techniques are utilized: the external approach and the endoscopic approach. The external approach, considered the gold standard in DCR surgery, offers distinct advantages owing to its comprehensive visualization of the involved anatomy. This method requires a creation of small incision in the lateral aspect of the nose, providing direct access to the nasolacrimal system. The surgeon benefits from a clear and unobstructed view, facilitating precise identification and removal of any possible obstructive material within the lacrimal sac. Consequently, the external approach ensures a higher likelihood of successful outcomes. Moreover, the external approach permits optimal exposure of the lacrimal sac and nasal bone, which may necessitate manipulation during the procedure. This unimpeded access enables meticulous intervention, ensuring thorough eradication of pathological elements and promoting favorable postoperative results. Furthermore, the external approach is particularly advantageous in cases necessitating revision surgery or those characterized by complex anatomical variations. It enables the surgeon to navigate through scar tissue or previous surgical alterations, facilitating meticulous correction of the lacrimal drainage. While the endoscopic approach has gained popularity due to its minimally invasive nature, it may not be universally applicable. The limited visualization and restricted access inherent to the endoscopic technique may impede the surgeon's ability to execute precise adjustments and address intricate anatomical anomalies.