목적: We aimed to compare the clinical accuracy between dacryocystography (DCG) and dacryoscintigraphy (DSG) in patients with epiphora. 방법:Fifty-six cases with epiphora who underwent DCG and DSG simultaneously were reviewed retrospectively. Findings of DCG are classified into no obstruction, canaliculi obstruction, common canaliculi obstruction, sac obstruction, duct-sac junction obstruction, duct obstruction, and stenosis. Results on DSG were also classified into no obstruction, pre-sac obstruction, sac obstruction, post-sac obstruction, and delayed secretion. Results of DCG were compared with those of DSG to evaluate the clinical accuracy of these tests in patients with epiphora who underwent lacrimal surgery. 결과:Abnormal findings of lacrimal passage were found in 68% on DCG and in 91% on DSG with statistical significance (p < 0.01). Overall agreement between both tests was 37.5%. Twelve cases with normal finding on DCG showed delayed secretion on DSG and 9 cases with stenosis on DCG showed anatomical obstruction on DSG. When sac and duct-sac junction obstruction on DCG were found, DSG detected block at more proximal level in 62.5% and 60%, respectively. However, when the obstruction was detected at the canaliculi level on DCG, block was detected at same level on DSG in 71.4%.When comparing results of these two tests with operative findings, agreement of DCG was 46.7% and all cases showed anatomical obstruction. Concordance rate of DSG was 40% and most cases were no obstruction and stenosis. 결론:DSG provided higher sensitivity than DCG to detect abnormality of lacrimal passage, although poor correlation was found between two tests. DCG is more precise than DSG in patient with definite anatomical obstructions, whereas DSG is more useful in cases without definite anatomical obstruction.