Purpose: Dacryocystorhinostomy via an eyelid incision has been described in Western literature. This study was undertaken to confirm that eyelid incision for dacryocystorhinostomy is suitable in Asians, because Asians have anatomic features that differ from those of Westerners. Methods: We performed dacryocystorhinostomy with an eyelid incision along skin wrinkles or relaxed skin tension lines in 57 eyelids of 49 patients from July 2003 to December 2004. The medical records of the patients were reviewed retrospectively. Results: Postoperative scars were easily camouflaged by wrinkles or relaxed skin tension lines of the eyelid without major complications. Conclusions: An eyelid incision can be used for dacryocystorhinostomy in Asians, regardless of the lack of a definite lower eyelid crease and the presence of epicanthus.