Diseases of the lacrimal system predominantly include various congenital anomalies, congenital and acquired dacryocystitis and lacrimal sac tumors. Newer treatment techniques have been developed for better results. The following congenital problems that can affect the nasolacrimal system: (i) Dacryostenosis, (ii) Anomalies of the sac, (iii) Anomalies of the puncta, and (iv) Anomalies of the canaliculi. Common causes of punctal stenosis include congenital causes, trauma, viral infections and autoimmune disorders. Congenital dacryocystitis results from nasolacrimal duct obstruction and can lead to various clinical manifestations, which include the following. Canaliculitis is caused by the infection of the canaliculi. Usually, it is chronic. It may also be iatrogenic after the instrumentation or placement of silicone plugs in the treatment of dry eyes. Acute dacryocystitis is manifested by the sudden onset of pain, erythema and edema overlying the lacrimal sac region. Tumors involving the nasolacrimal drainage system are rare and more than 90% of these tumors are of the epithelial origin.