Chronic canaliculitis is an uncommon disease with a protracted course. Its management is prolonged and difficult. An elderly lady was diagnosed to have left lower chronic purulent canaliculitis. Conserva- tive treatment alone did not effect a complete cure. Canaliculotomy with removal of sulphur granules and canalicular curettage also had to be performed to achieve a permanent cure. Unlike many cases of canaliculitis, this patient presented numerous complications confined to the canaliculus. To the best of our knowledge, this is the first report of Actinomyces naeslundii (A. naeslundii) causing chronic puru- lent canaliculitis and associated complications. A. naeslundii canaliculitis should be considered in the differential diagnosis of chronic conjunctivitis with epiphora.