A consecutive series of 122 dacryocystorhinostomies is reviewed, and a surgical technique which preserves the anterior lacrimal crest and eliminates the need to create mucosal flaps is described. The success rate of this simplified technique is 89%. The success rate rises to 94% following secondary revisions. This is comparable to more complicated procedures. Canalicular and common punctal stenosis are not found to be contraindications to dacryocystorhinostomy for obstruction of the nasolacrimal duct but do lower the success rate. Eighty-one percent of patients with concomitant canalicular disease and nasolacrimal duct obstruction were cured by dacryocystorhinostomy with silicone intubation. A success rate of 98% was achieved in patients without preoperative canalicular disease.