: To compare the effectiveness ofexternal dacryocystorhinostomy(DCR) with Silicone tube(SI) placement versus Silicone tube with application of Mitomycin–C(MMC) in Nasolacrimal Duct Obstruction(NLDO).: The study was conducted in the department of Ophthalmology, at BRD medical college, Gorakhpur, U.P., India between March 2018 to June 2019.It was a prospective randomized study, where we studied 88 eyes from patients who presented with simple epiphora due to primary acquired NLDO. The patients were randomly assigned into two groups, where one group was subjected to external DCR along with the placement of a silicone tube ,and the other group underwent silicone tube placement followed by the application of 0.2mg/ml of anti-metabolite MMC.After a 6 month follow-up, it was noted that there was no statistically significant difference between the two groups, i.e., when considering patients with simple epiphora secondary to primary acquired NLDO, external DCR with silicone tube and silicone tube with MMC(0.2mg/ml) application are at par with each other in terms of effectiveness. However, silicone intubation with MMC is a minimally invasive procedure when compared to external DCR with silicone tube placement.