Objective:To investigate the application and clinical effect of mucosal flap suture and t-tube implantation in dacryocystorhinostomy.Methods: From November 2016 to March 2022, 26 patients with 31 eyes who had dacryagogatresia were treated with mucosal flap suture and t-tube implantation.To analyze the clinical data,summarize the operative methods and observe the clinical efficacy.Result: Postoperative follow-up was conducted for 6-48 months,the recovery rate was 61.3% (19/31), the effective rate was 12.9% (4/31), the effective rate was 9.7% (3/31), the ineffective rate was 16.1% (5/31), the total effective rate was 83.9% (26/31).Conclusion: In Difficult dacryocystorostomy, nasal endoscopic mucosal flap suture and t-tube implantation have smaller trauma and the curative effect is exact.We should follow-up after surgery regularly to get better curative effect.