AIM: To investigate the etiology, diagnosis, management and outcome of epiphora referrals to an oculoplastic practice. METHODS: Retrospective chart review of patients referred for epiphora to an oculoplastic clinic between 2005 and 2009. Patient demographics, past history, ophthalmic examination, treatment and outcome were analyzed. RESULTS: There were 237 subjects with a primary complaint of epiphora. They included 130 (55%) females and 107 (45%) males with an average age of 55.9±25.9y. The most common cause of epiphora was lacrimal obstruction (46%); followed by multifactorial epiphora (22%), reflex tearing (22%) and eyelid malposition (11%). Differences in prevalence of etiology were noted in terms of age and gender distribution. Of the 182 (77%) patients who returned for follow up, 41 (23%) reported a complete resolution and 102 (56%) reported a significant improvement in their symptoms. CONCLUSION: Epiphora is a common condition with many causes. A thorough history and examination are required to provide the appropriate treatment tailored to the underlying cause.