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To compare the success rate of monocanalicular versus bicanalicular silicone intubation of incomplete nasolacrimal duct obstruction (nasolacrimal duct stenosis) in adults.In a retrospective, nonrandomized comparative case series, 48 eyes of 44 adult patients with nasolacrimal duct stenosis underwent endoscopic probing and either bicanalicular (BCI; n = 22 eyes) or monocanalicular (MCI; n = 26 eyes) nasolacrimal duct intubation under general anesthesia. “Complete success” was defined as complete disappearance of the symptoms, “partial success” as improvement with some residual symptoms, and “failure” as absence of improvement or worsening of symptoms at last follow-up. The last follow-up examination included diagnostic probing and irrigation if there was not complete success.Patient ages ranged from 31 to 90 years (mean, 69; SD, 11.5). Forty-five tubes were removed 6 to 17 weeks (mean, 9.1; SD, 3) after surgery. Premature tube dislocation and removal occurred in one eye with BCI and in two eyes with MCI. Follow-up ranged from 6 to 52 months (mean, 14.9; SD, 8.4). The complete success rate was nearly the same in eyes with MCI (16/26, 61.53%) and BCI (13/22, 59.09%). Partial success (MCI: 8/26, 30.76%; BCI: 1/22, 4.54%) and failure (MCI: 2/26, 7.69%; BCI: 8/22, 36.36%) were, however, significantly different (p = 0.010). Complications included 3 slit puncta with BCI and 4 temporary superficial punctuate keratopathy after MCI.MCI had virtually the same complete success rate as BCI, a higher partial success rate than BCI, and a lower failure rate than BCI in treatment of nasolacrimal duct stenosis in adults.