Background <p>Nasolacrimal duct obstruction following zygomaticomaxillary complex fracture surgery is a rare but significant complication. The proximity of the lacrimal system to the medial infraorbital rim makes it susceptible to injury. Patients with secondary acquired nasolacrimal duct obstruction experience symptoms such as epiphora and discomfort. Management options range from conservative to surgical interventions. This case report presents a unique instance of secondary acquired nasolacrimal duct obstruction after surgical fixation of a displaced zygomaticomaxillary complex fracture and its subsequent management.</p> Methods <p>The patient underwent a multi-step treatment approach, including removal of the infected hardware and endonasal dacryocystorhinostomy.</p> Result <p>At the 1-year postoperative follow-up, the patient showed no signs of re-infection or complications.</p> Conclusion <p>This report highlights the importance of interdisciplinary collaboration between ENT specialists and maxillofacial surgeons in managing hardware-related secondary acquired nasolacrimal duct obstruction, emphasizing the need for prompt and effective treatment to prevent long-term complications.</p>