Dermoid cysts are congenital benign anomalies originating from ectodermal tissue during neural tube closure. These cysts may present in different region but the incidence of head and neck dermoid cysts is only seven percent. Dermoid cyst in superior-medial orbital region is a rare condition and its routine management has been through open approaches.

A young man with right medial canthus enlarging mass from four years ago had also complaint of epiphora with worsening in cold weather. The patient does not have any sign of nasal obstruction, postnasal discharge, vision alteration or limited eye movements. In CT scan a well-defined mass was noticed in superior-medial orbital region. Based on clinical and radiological findings the patient underwent endonasal endoscopic surgery.

The cyst was evacuated and then removed completely. Pathological evaluation was consistent with dermoid cyst. Postoperatively, the patient’s epiphora resolved completely.

We presented a minimally invasive technique for treatment of orbital dermoid cyst with acceptable results and no morbidity.