The article presents the results of a long-term study on application of cytological examination in dacryology. A total of 194 patients (288 eyes) with dacryostenosis, dacryocystitis, and obliteration of lacrimal canaliculi orifices were assessed. Pathogenically oriented conservative treatment, in accordance with the results of clinical, instrumental, and cytological examination, was given to all patients with dacryostenosis. Patients with dacryocystitis and lacrimal canaliculi orifice obliteration received surgical treatment: microendoscopic dacryocystorhinostomy, transcanalicularis laser dacryocystorhinostomy, and microendoscopic canaliculocystorhinostomy. Cytological examination, among other methods, was used to evaluate treatment results. The method has been demonstrated as objective and can be included into the assessment and follow-up algorithm for patients with lacrimal ducts pathology.