Orbital hemorrhage during dacryocystorhinostomy (DCR) is a very rare but potentially devastating complication of this procedure. It is probably due to trauma to the anterior ethmoidal artery, which has a variable course and may have branches close to or in the surgical site. Increasing resistance to retropulsion of the globe is an important sign of orbital hemorrhage. If the hemorrhage does not resolve spontaneously, direct decompression of the blood within the orbit is necessary. The authors review their experience with this complication of DCR.