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Purpose:.To evaluate the application of a high-frequency electrosurgical scalpel and methylene blue staining in the en-donasal dacryocystorhinostomy. Methods:.This retrospective study included 37 patients (43 eyes).undergoing endonasal dacryocystorhinostomy in our hospital between 2011 and 2013 using methylene blue staining of the lacrimal sac and a high-frequency electrosurgical scalpel for cutting nasal mucosa, intraoperative stanch, and fixation of lacrimal sac and nasal mucosal flaps. Surgical efficacy, in-traoperative challenges,.and corresponding handling methods were evaluated and summarized. Results:.Among 43 eyes,.42 were successfully cured (97.7%) and the symptoms in 1 eye were improved (2.3%). Total effi-cacy rate was 100%. All surgeries were successfully performed.. No severe intraoperative complications were observed. Conclusion:.A high-frequency electrosurgical scalpel,.com-bined with methylene blue staining of the lacrimal sac, is effi-cacious for nasal mucosal cutting,.intraoperative stanch,.and fixation of mucosal flap by cauterization,.which significantly alleviates intraoperative complications and enhances surgical success rate..It deserves widespread application in clinical practice. .(Eye Science 2014; 29:25-29).