The aim of this study was to report the authors’ experience with endoscopic dacryocystorhinostomy (ED) in a paediatric population and to evaluate the effect of surgical site reassessment on anatomy and clinical outcomes. The study included 47 children <18 years (19 males, 28 females: aged 1.5 to 17 years) who underwent primary ED in a single centre study. There were 68 procedures overall. Indications for surgery included epiphora non resolving after one-year-old and / or resistance to previous treatment strategies. Unilateral surgery was undertaken in 26 and 21 were bilateral. All but two were straightforward surgery. There were no major complications. Minor complications were noted in five unilateral and one bilateral case including adhesions, epistaxis and postoperative infection. Anatomy success included free flow of irrigation and patency of the ostium. Assessment by nasal endoscopy was done after six to eight weeks postoperatively for 52 cases showing 94.2% success rate. Clinical success was reported for 92.6% (63 procedures). All patients had had silicone intubation to maintain a patent ostium and 52 had surgical removal of this at six to eight weeks. Others were premature loss or passing and therefore removal was not needed. The authors conclude ED was practical and safe in their paediatric population and compares well to the external approach due to high success rate and low rate of complications.