background/aims Endonasal endoscopic dacryocystorhinostomy (EN-DCR) is now a well-established procedure to relieve nasolacrimal duct obstruction. In the past, attempts have been made to comment on the anatomical success of the procedure. However, no studies have been conducted to evaluate patient satisfaction with the EN non-laser DCR procedure in comparison with the surgeon's experience. methods Records of patients undergoing EN-DCR and external DCR (ET-DCR) surgery were reviewed. A telephone questionnaire was used to assess patient satisfaction with both procedures. Data were analyzed with Fisher's exact test and the chi-square test. results Twenty primary EN-DCR's and 16 revision EN-DCR's were performed by the same surgeon (RM) over a three-year period. At last review, 89% of ET-DCR and 75% of EN-DCR procedures were noted to have a patent sac washout performed in the eye clinic. A telephonic interview revealed no significant difference between the surgical outcome [15/20 (75%)] and patient satisfaction [14/20 (70%)] with the primary EN-DCR procedure. Patient satisfaction with revision EN-DCR [10/16 (63%)] was slightly poorer than the surgical outcome recorded for revision EN-DCR [12/16 (75%)] but this was also not statistically significant. Telephonic interview was possible for 42/64 (66%) patients undergoing primary external ET-DCR's and a total of 36/42 (86%) patients were satisfied with the procedure. Patient age, laterality, duration of symptoms, previous ocular procedures or preexisting ocular disease and associated ENT procedures did not alter the surgical result or patient satisfaction in either group. conclusions This study suggests that patient satisfaction with endoscopic endonasal non-laser DCR for primary or revision DCR surgery is comparable to that with the external-DCR technique since there was no significant difference in patient satisfaction between the two groups of patients. Patient perception of their symptomatic improvement was lower (though not statistically significant) in relation to the final clinical assessment of the outcome of both primary and revision EN-DCR.