Actinomyces odontolyticus is a predominant Actinomyces species in the oral cavity, pharynx, and distal esophagus. We report a rare case of primary chronic lacrimal canaliculitis caused by A. odontolyticus. A 63-year-old woman presented with left eye epiphora for three years associated with medial upper lid swelling, redness, and chronic yellowish discharge. After clinical examination and investigations, she was successfully treated with topical cefuroxime 5%, topical fluorometholone 0.1%, and intracanalicular syringing with cefuroxime 5%. Spontaneous extrusion of canaliculiths led to complete resolution.