Purpose To discuss and illustrate various lacrimal punctal abnormalities and their management. Synopsis Lacrimal puncta play an important role in the drainage of the tears produced by the lacrimal gland. The disorders of the puncta can be isolated or in association with canalicular or nasolacrimal duct anomalies. Various syndromes have been associated with punctal disorders. A simple, methodical clinical examination has a great role in the diagnosis of these conditions. In this video, we classify, define and discuss punctal abnormalities, embryology, histology, etiology, examination and management options available. Also, effective and commonly performed remedial surgeries are demonstrated.