To compare and analyse the efficacy of dacryocystorhinostomy (DCR) with or without stent intubation for the treatment of primary nasolacrimal duct obstruction. The English and Chinese literature of randomized controlled trials (RCTs) about comparison of dacryocystorhinostomy with and without stent intubation for treating primary nasolacrimal duct obstruction are selected. The related grey literature and database are explored. Two reviewers independently screen the studies for eligibility, evaluate the quality and extract the data from the eligible studies with confirmation by cross-checking. Divergences of opinion are resolved by discussion or consensus involving a third reviewer. Meta-analyses are performed by Rev Man 5.3. Ten RCTs involving 887 cases meet the inclusion criteria. The success rate of DCR with stent intubation is significantly better than that of DCR without stent intubation, especially in the external DCR subgroup. Key words: Dacryocystorhinostomy(DCR); Stent intubation; Meta analysis