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Objectives: The goal of the present study was, therefore, to evaluate the diagnostic effectiveness of dacryoscintigraphy (DSG) in children with epiphora, find out demographic factors associated with epiphora and assess treatment outcomes guided by DSG. Material and Methods: This particular study was a retrospective study. The records of all previous DSG images that had been done in children aged between 4 years and 12 years for the indication of epiphora were re-evaluated. A total of 81 children were studied. Out of 81 cases, 12 cases were excluded from the study due to inadequate clinical data. A total of 69 cases (24 had bilateral and 45 had unilateral symptoms) were included in the study cohort. Results: A total of 138 eyes were studied, among which 45 eyes (20 boys and 25 girls) were without epiphora and 93 eyes (58 boys and 35 girls) with epiphora. There were no significant differences in gender ( P = 0.50) and age distribution ( P = 0.70) between eyes with and without epiphora. DSG in 75 of 93 eyes with epiphora (80.7%) and 13 of 45 eyes without epiphora (28.9%) showed obstruction in the lacrimal drainage system (LDS). There was a statistically significant difference in duct obstruction between eyes with and without epiphora ( P = 0.001). Eighteen of 93 eyes with epiphora (19.3%) showed patency, and 32 of 45 eyes without epiphora (71.1%) showed patency, which was also statistically significant ( P = 0.001). Sensitivity and specificity of DSG in the detection of abnormalities in the LDS in children with epiphora were 80.7% and 71.1%, respectively. In the case of 75 eyes with epiphora showing obstruction on DSG, treated by surgery, out of 75 eyes, 61 eyes improved. The overall success rate of surgery according to the DSG findings was 81.3%. Conclusion: DSG was found to be simple, easy to perform, safe, noninvasive, objective, and more physiological, with high diagnostic accuracy in the evaluation of children with epiphora and also gives added advantage in the planning of surgery.