Once the endoscopic surgeon is well trained and achieves good knowledge of the Para nasal sinuses, it is only natural that the scope of endoscopic sinus surgery would be expanded to other adjoining areas of the nose and sinuses such as nasolacrimal apparatus, Orbit, and skull base. This chapter gives the reader a detailed account of anatomy, physiology, pathology, of common and certain specific conditions that can affect the nasolacrymal system. A proper pre operative assessment is required and imaging of the nasolacrimal system is performed prior to endoscopic DCR. Important clinical tips are given regarding Endoscopic DCR. Complications of the procedure especially of the restenosis of the stoma are discussed and various points made in relation to the technique to avoid such complication following endoscopic DCR. Complications to prevent transsphenoidal pituitary surgery are detailed in step by step fashion. Several intra operative, cadaver dissection and CT imaging is used to illustrate the salient points for preventing complications in pituitary surgery. A brief account of mucoceles, fungal infections and tumours that can affect paranasal sinuses is outlined. Intra orbital complications of acute sinusitis are discussed with various clinical, CT imaging and intra operative photographs. Important points are made to be especially careful while operating in this “crowded area” of the orbit in the presence of gross inflammatory oedema, vascularity and distorted anatomical landmarks because of the disease process.