Introduction  Bilateral simultaneous endoscopic dacryocystorhinostomy (endo DCR) is rarely performed by surgeons, partly due to traditional teaching of performing surgery on one side first followed by the other after few months, partly due to fear of failure and imparing the patient’s daily activity caused by bilateral nasal surgery. Hence vast majority of surgeons continue to perform endo DCR in a staged manner, repairing one side followed by the other after few months Objective  To evaluate the results of simultaneous bilateral Endo–DCR and its impact on the quality of life of the patients. Methods  We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo–DCR between Jan 2018 and Dec 2018 at our tertiary care hospital. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; comparison of complications with cases undergoing only unilateral endo–DCR. Results  A total of 30 cases were bilateral (60 sides). Postoperative success was documented in 56 of the 60 sides (93.33%), with a mean follow–up duration of 18 months. Four failed sides were reported where both sides failed in same patient, while the remaining 2 were in 2 separate cases. For Bilateral Endo–DCR the preoperative symptom score was 38.5±4.22(mean ± SD) and postoperative symptom score was 4.23±1.67 which was significantly lower (mean ± SD). In Unilateral Endo–DCR the preoperative symptom score was 35.9±10.9(mean ± SD) and postoperative symptom score was 4.46±1.78 which was significantly lower (mean ± SD). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. No significant difference was seen in complication rates between bilateral and unilateral cases. Conclusion  Our results support that a simultaneous bilateral endo–DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and has no significant increase in complications.