AIM: To explore the clinical effect of high dacryocystorhinostomy(DCR)combined with RS lacrimal duct recanalization on the treatment of chronic dacryocystitis.METHODS: Retrospective study. From January 2021 to January 2023, 110 patients(110 eyes)with chronic dacryocystitis treated in our hospital were collected and grouped according to the treatment method. The 55 eyes in the control group were treated with high DCR combined with suction cotton, and the 55 eyes in the monitored group were treated with high DCR combined with RS lacrimal duct recanalization. Follow-up for 6 mo, the clinical efficacy, quality of life, and complications were compared.RESULTS:At 6 mo after surgery, the monitored group had higher anatomical success rate than the control group(96.4% vs 83.6%), and had higher total effective rate than the control group(98.2% vs 78.2%; both P<0.05). At 6 mo after surgery, both groups had increased the Shot-Form Health Status Survey-36(SF-36)scores, with the monitored group having higher scores than the control group(all P<0.05); there was no statistical difference in complications between two groups(10.9% vs 20.0%, P>0.05).CONCLUSION:High DCR combined with RS lacrimal duct recanalization is safe and effective in treating patients with chronic dacryocystitis.