Congenital nasolacrimal duct obstruction (CNLDO) is the most common cause of epiphora in infants. It occurs due to the failure of canalization of the distal end of the nasolacrimal duct (NLD) [1]. There is a mucous membrane obstruction at the lower end of NLD, found in up to 20% of newborn infants [2]. Spontaneous resolution occurs in (>90%) during the first 12 months of life, and the majority of children do not require surgical treatment [3]. In cases where the spontaneous opening of the membrane fails, persistent epiphora occurs (Figs. 41.1, 41.2, 41.3, 41.4, 41.5, 41.6, 41.7, 41.8, 41.9, and 41.10).