Congenital nasolacrimal duct obstruction (CNLDO) is a developmental disorder of the lacrimal system that affects infants from birth and may persist into the first year of life or beyond. Epiphora is the usual presenting symptom, which, along with mucous discharge and a high tear meniscus, can be bothersome for parents and occasionally results in local ocular and skin irritation. This article will cover the various etiological subtypes, diagnosis, and management options.