Introduction: 2-6 % of full term newborn children manifest symptoms of congenital nasolacrimal duct obstruction. The most frequent presentation is tearing associated with mattering of the eyelashes and recurrent infection. We designed a study to document the clinical presentation, management and outcome of 100 consecutive cases of congenital nasolacrimal duct obstruction seen in a regional institute of ophthalmology. Aim: Clinical presentation, management and outcome of 100 consecutive cases of congenital nasolacrimal duct obstruction seen in a regional Institute of Ophthalmology. Material and Methods: 100 consecutive cases of congenital nasolacrimal duct obstruction, seen in our regional institute of ophthalmology were enrolled from June 2011 to June 2015. Patients of age less than 6 months were treated with massage four times a day and topical moxifloxacin 0.5% as and when discharge was seen. Probing was reserved for patients with acute infection or acute dacryocystitis in children aged 6 months to one year. Probing was the treatment of choice for children between one year and four years. Silicone intubation was done in patients who failed probing. Dacryocystorhinostomy was the procedure of choice for patients who failed probing or silicone intubation and as the primary procedure in children greater than four years. Observations and Results: Massage with topical antibiotics were given to all patients. Probing was done in 37 children. Repeat probing was required in nine children. Two out of these nine children required probing with silicone intubation with inferior turbinate in fracture. Four children were managed with dacryocystorhinostomy. The success rate of various procedures were 60% for conservative management, 70.3% for probing, 77.8% for repeat probing, 50% for probing with silicone intubation with inferior turbinate in fracture and 75% for dacryocystorhinostomy. Conclusion: Children with congenital nasolacrimal duct obstruction can be successfully managed with good outcomes.