The authors aimed to report the clinical outcomes of antegrade balloon dacryocystoplasty (DCP) followed by pushed-type monocanalicular (MC), combined as a primary management for congenital nasolacrimal duct obstruction (CNLDO). This was a retrospective study of 62 eyes (48 patients) with mean age of 24.13 months (range 12-66): 25 male, 37 female. There were 14 bilateral and 34 unilateral cases. Mean duration of tube insertion was 9.48 days (4-15). Surgical success was noted in 60 eyes. Two eyes had persistent obstruction with epiphora. Others had no intra- or postoperative complications. Early stent loss occurred in two eyes. Limitations of this study are its retrospective nature, small sample size and limited follow-up of one month providing short-term outcomes only. Given the high early success rate, the authors propose further study with a larger population and longer follow-up. They propose this combined surgery as showing potential for high success rates.