Several tests and examinations are necessary for an accurate diagnosis of disorders of the lacrimal drainage system. The AA studied 100 patients with epiphora, divided in two groups. Forty patients, first group (I), aged between 4 and 78 years old (mean age 47.8 +/- 9.6 years), were examined using the classical tests for the study of epiphora, sequential dacryoscintigraphy (SD) and conventional subtraction macrodacryocystrography (CSMD). In the second group (II), 60 patients (aged 45.5 +/- 8.7 years) were studied using the classical tests and by digital subtraction macrodacryocystography (DSMD). The results showed that when functional epiphora is present, there is no difference between a simple clinical approach and sequential dacryoscintigraphy. However, when information is needed regarding choice of surgical approach, DSMD appears to give the best results.