A 36-year-old man had congenital fistulae of the palpebral lobes of the lacrimal glands, with orifices bilaterally in the intermarginal strip of his upper eyelids near the external canthi. The left fistula was cystic and had become chronically inflamed. Because antibiotic therapy was unsuccessful, excision was necessary. Congenital fistulae are extremely rare, forming a lateral and tarsal group, each group having typical characteristics.