Objective: To determine if dacryocystorhinostomy or silicon intubation is more effective in treating nasolacrimalduct obstructionStudy Design: A Randomized Controlled Trial StudyPlace and duration of study: This research was conducted over a six-month period, from October 9, 2021, to April 9,2022, at the Department of Clinical Ophthalmology, Khyber Girls’ Medical College, Hayatabad Medical Complex(HMC), Peshawar.Materials and Methods: The study comprised 446 patients with nasolacrimal duct blockage (NLDO). Eachpatient was split up into two cohorts. Group A had cryocystorhinostomy (DCR) with silicon intubation, whereasGroup B underwent DCR without intubation.Results: The average age of the sample was 35.1 + 9.2 years. The mean age of Group B was 35.2 + 9.1 years,whereas the mean age of Group A was 34.9 + 9.3 years (p 0.730). Group A consisted of 61.9% males and groupB had 56.5% males (p 0.248). The average number of days that symptoms persisted was 11 + 3.2 days in group Aand 10.4 + 2.9 days in group B (p 0.082). As determined by the overall remission of symptoms, group A’s efficacywas 79.4% at follow-up, whereas group B’s was 69.5% (p 0.017).Conclusion: For those with NLDO, silicon intubation significantly boosts the efficacy of DCR when compared toDCR without intubation.Key Words: Nasolacrimal duct obstruction, dacryocystorhinostomy, intubation, silicon, and efficacy.