If typical congenital nasolacrimal obstruction symptoms occur during the first few days of life immediate treatment is necessary. At the latest within two weeks the benefits of medication and massages of the lacrimal sac should be exploited to treat these conditions. It should be pointed out in particular that persisting membranes may perforate spontaneously. Should this treatment fail, high-pressure syringing and probing with Bangerter probes under local anesthesia must be performed very early. Due to the fact that the less complicated high-pressure syringing is often unsuccessful it is followed without delay by probing. If the ophthalmic surgeon is skilled, proceeds with care, and observes certain technical details complications can be avoided. The treatment described only fails in exceptional cases.