We report a case of a 10-year-old patient presented with recurring nasolacrimal duct obstruction post-lacrimal sac cyst extirpation in which CT scan revealed a solid lesion that was more depicted by contrast-enhanced image. The initial surgery and flap creation had inadvertently led to a mucosal shortage, posing a challenge for the subsequent procedure, which aimed to create a Dacryocystorhinostomy (DCR). In a challenging approach, a buccal mucous membrane graft was employed to address the lack of mucous membrane required for the DCR. Over the course of five years, there was no recurrence of the cyst, signifying the success of this innovative treatment method of using buccal mucous membrane graft for external DCR. © 2024, Ophthalmological Society of Pakistan. All rights reserved.