The true incidence of endonasal dacryocystocele in the newborn is prob
ably underestimated; the number of cases in the last few years has inc
reased with better imaging techniques and diagnostic tools. Although i
nfrequent, it must be considered in the differential diagnosis of neon
atal respiratory distress and nasal obstruction. These children typica
lly present an endonasal mass under the inferior turbinate, most often
associated with inner canthal swelling. This series of four patients
represents one of the the largest to be reported since the first publi
cation on the subject by Goralowna in 1979.