Purpose: To compare success and extrusion rates of the monocanalicular and bicanalicular Crawford intubation systems (JEDMED Instrument Company, St. Louis, MO).; Methods: A retrospective review of all children who were diagnosed as having congenital nasolacrimal duct obstruction and treated with lacrimal intubation from 2005 to 2014 was performed. The total number of eyes included was 168 (75 and 93 right and left eyes, respectively). Bicanalicular intubation was used in 80 eyes (bicanalicular group) and monocanalicular intubation was used in 88 eyes (monocanalicular group).; Results: Success occurred in 63 (78.75%) and 82 (93.18%) eyes in the bicanalicular and monocanalicular groups, respectively (P =.00653). Extrusion occurred in 24 (30%) and 11 (12.5%) eyes, respectively (P =.00528).; Conclusions: Monocanalicular intubation for congenital nasolacrimal duct obstruction is superior to bicanalicular intubation. Extrusion and reoperation rates are significantly lower.