Objective To determine the clinical efficacy of lacrimal endoscope in the obstruction of lacrimal canaliculi. Methods Totally 24 aged patients (mean age 65 years, 24 eyes) with lacrimal canaliculi obstruction in our department from March 2014 were subjected in this study. After the lacrimal endoscope was inserted into the lacrimal canaliculi to explore the blockage, the block organization was removed with the help of 980 laser to make the lacrimal duct unobstructed. Then a silicone tube was placed and fixed in the lacrimal canaliculi. Results The cohort was followed up for 3 months after the silicone tube intubation with lacrimal endoscopy. There were 18 cases succeeded with unobstructed lacrimal duct, and the other 6 cases failed. Conclusion Lacrimal duct endoscopy is helpful to directly find the blockage, and 980 laser makes minimal damage and restores the physiological structure of lacrimal canaliculi with mild postoperative impairment. Combined with silicone tube intubation, this treatment is ideal in treatment of the obstruction of lacrimal canaliculi.