In patients with bilateral symptoms of lacrimal pathways occlusion, the endonasal dacryocystorhinostomy (EDCR) and conjunctivo-dacryocystorhinostomy (CDCR) may be performed simultaneously or consequently. The simultaneous bilateral surgery does not worsen the surgery results. The advantages of this procedure are one anesthesia only, only unsubstantial extension of the surgery duration, and shorter sick leave as well. The authors performed during the period from 1995 to 2007 altogether 630 primary EDCRes and 117 CDCRes. In 92 patients, 184 simultaneous dacryocystorhinostomies were performed. Out of 164 evaluated surgeries, the good results were obtained in 150 cases (91.5 %). Out of 40 simultaneously performed CDCRes (20 patients), they were successful in 14 patients. Unsuccessful they were in 3 patients in whom the silicone drainage implant was used.