One thousand five hundred twenty-one patients (2,038 eyes) with congenital nasolacrimal duct obstruction were reviewed at The Children's Hospital of Philadelphia. Of these, 174 patients with congenital dacryostenosis involving 192 eyes underwent polymeric silicone (Silastic) intubation to treat the dacryostenosis. All patients had undergone at least several months of conservative management consisting of topical antibiotics and massage. All had undergone at least one probing and irrigation. Congenital dacryostenosis as well as resolution of symptoms were confirmed by clinical examination and use of a modified dye disappearance test. In 192 eyes the overall success rate was 83.33%. When broken down into age group, progression of success rates were from 100% in the 6-13 month age group to 79.6% in the over 24-month age group. Success rates differed significantly according to how long the Silastic tubing remained in position, especially in older age groups. The data suggest that Silastic intubation is a successful means of treating congenital dacryostenosis and that one should consider leaving the silastic in place for 6 months when possible.