One hundred nineteen dacryocystorhinostomies were reviewed and were found to be most commonly performed on females in their seventh decade, with silent epiphora being the most common presenting symptom. Trauma was the single most frequent cause of surgery in males and required complex reconstruction in most cases. Three of the seven dacryocystorhinostomy failures occurred in these traumatic dacryostenosis cases. An unusually high percentage of dacryocystorhinostomy surgery was performed on women who had had previous hysterectomies or serious gynecologic pathology.