PurposeTo examine the effect of age at time of congenital nasolacrimal duct obstruction (CNLDO) intervention on symptom resolution and reoperation rates in patients with Down syndrome (DS). MethodsThe medical records of patients with DS and CNLDO between 2012 and 2021 were reviewed retrospectively. Age at the time of first stent placement was utilized to categorize patients into age groups <3 and >3 years of age. Epiphora resolution at last office visit and restenting rate were used as outcome measures. ResultsA total of 49 patients with DS and CLNDO were identified between 2012 and 2021; of these, 17 had received surgical stent placement with appropriate follow-up. Epiphora resolution (X21= 0.78, P = 0.33), restenting rate (X21 = 2.84, P = 0.09), cumulative stent duration (P = 0.33) and number of stent placement operations (P = 0.98) were not significantly different between the age groups. There was no significant difference between stent duration <1 year or >1 year with regard to epiphora resolution (X21 = 0.91, P = 0.34). ConclusionsSuccess of stent placement and reoperation rates among patients with DS and CNLDO were not associated with age and duration of stent intubation. Intervention at later ages may still be beneficial for symptom resolution in patients with DS.