Abstract: Objective To investigate the therapeutic effect of retrograde lacrimal stent placement in patients with nasolacrimal duct obstruction under nasal endoscopy. Methods A total of 94 patients with nasolacrimal duct obstruction were enrolled in the study. The patients were divided into a study group and a control group with 47 cases in each group by random number table method. The study group was treated with retrograde lacrimal stent placement under nasal endoscope, while the control group was treated with simple lacrimal probing. The total effective rate, time of unobstructed lacrimal irrigation, elimination time of epiphora symptoms, incidence of complications and recurrence rate were compared between the two groups. Results The total effective rate of the study group was significantly higher than that of the control group (93.62% vs. 82.98%, P<0.05). The time of unobstructed lacrimal irrigation and relief of epiphora symptoms in the study group were shorter than that in the control group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). The recurrence rate of disease in the study group was significantly lower than that in the control group (4.26% vs. 17.02%, P<0.05). Conclusions Compared with the simple lacrimal passage probing operation, endoscopic retrograde lacrimal stent placement can improve the therapeutic effect, shorten the time of unobstructed lacrimal irrigation, relieve the symptoms of epiphora, reduce the recurrence rate, while do not increase the complications. It is a safe and effective treatment for nasolacrimal duct obstruction.