The principality of Monaco is communicated with the rest of the world via railways normally along the French coast, through its large harbour receives most of the goods and by car along rather bendy roads.
There is no space for an airport because of its relatively small size, unless the population were to decrease drastically to half of what it is now, to allow construction of a small airstrip.
A landlocked nation between Spain and France, Andorra is the largest country on the list that lacks an airport, the closest is Barcelona El Pray in Spain. It does, however, have three heliports for emergency purposes.
The Vatican city
Despite it's location in the heart of Rome, the Vatican city has no alternative sea or river, transportation and is almost entirely on foot.
As the fifth smallest country in the world, San Marino does not suffer from inaccessibility as it is only nine miles from the famous Federico Fellini International airport.
Visitors would need to enter a car, boat or popular rail system from nearby Swiss or Austrian rail stations. It is tiny but powerful, with one of the highest GDPs per capita and one of the lowest national debts.
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