The objectives of the study were to retrospectively analyze the efficacy of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (END-DCR) and compare it with external dacryocystorhinostomy (EXT-DCR).For the comfort of the patients, the procedures were performed under general anesthesia. Intraoperatively during the END-DCR, we applied a cotton pledget soaked in a 0.5 mg/mL solution of MMC for 2.5 minutes. In each patient, a silicone tube was placed into the nasal cavity via the superior and inferior punctae and fixed in the vestibule. We retrospectively analyzed the medical records of patients who underwent END-DCR and EXT-DCR.A retrospective review was performed on the medical records of 43 patients (with a total of 49 affected cases) who were admitted to our clinics with a primary complaint of epiphora. The overall success rates were 91% in END-DCR+MMC and 71.5% in EXT-DCR.Mitomycin C, in appropriate doses, minimizes postoperative granulations and fibrosis. Adjunctive use of MMC is considered to increase the success rate of END-DCR.