Objective: The purpose of the current study is to determine the age-related feasibility rate of the intranasal endoscopic prelacrimal recess approach (PLRA) in pediatric patients. Methods: Computed tomography (CT) images of 379 patients under 18 years old were analyzed retrospectively. The anteroposterior dimensions of the medial bony wall of the prelacrimal recess (PLR) were measured on 758 sides. The feasibility of the PLRA was evaluated according to the criteria of Simmen et al., for each age and three age groups based on trends in the change of the width of the PLR. Results: Less than half (45.9%) of pediatric maxillary sinuses (MS) were found to have the favorable anatomy (width of PLR > 3 mm) to perform the PLRA. The cut-off value for age regarding the feasibility of the PLRA was nine years old. Following an evaluation of the groups, the proportions of the MS with favorable anatomy for the PLRA were 5.7% in Group I (age 0-4 years), 33.3% in Group II (age 5-8 years), and 55.1% in Group III (age 9-17 years). In group III, the feasibility rate for the PLRA was greater in boys (62.1%) than in girls (48.3%). No difference in the feasibility rate was found between the right and left sides. Conclusion: The overall feasibility rate for the PLRA in pediatric patients under 18 years of age is 46%. In patients aged 9-17 years, the feasibility rate for the PLRA is > 50%. (c) 2021 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.