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Thirty-three lacrimal pathways (48.5%) were identified to have obstructions on the same level between DCG and dacryoendoscopy. Among the 30 lacrimal pathways (44.1%) that were normal by DCG, obstruction was revealed in 22 cases by dacryoendoscopy, with 11 cases in the common canaliculus. Additional useful information on the cause of obstruction and identification of multiple obstructed sites was provided by dacryoendoscopy. Conclusions DCG and dacryoendoscopy showed moderate agreement in detecting lacrimal pathway obstruction. Dacryoend