Lacrimal bypass surgery is the preferred surgical procedure in cases with epiphora, where the canalicular and lacrimal saccal injury is not repairable by both canaliculodacryocystorhinostomy or by conjunctivodacryocystorhinostomy. Holmium:YAG (Ho:YAG) laser is a useful surgical tool that allows the surgeon to perform an easier and faster procedure by the aid of its hemostatic and less traumatic disruptive properties. The surgery can be performed under general anesthesia or local anesthesia. Bowman probe can be used. 0.6–0.8 J at 10 Hz (6 to 8 watts) for soft tissues and 0.8–1.0 J at 10 Hz (8 to 10 watts) for the bone is usually the most adequate energy. Complications are epiphora due to obstructed tubes by secretions, inadvertent thermal damage to the globe and intranasal structures, granuloma formation, corneal erosion caused by rubbing of tube or suture, foreign body sensation and discomfort. Nasal steroid sprays, topical antibiotic and steroid drops to the operated eye are used in postoperative care.