Congenital nasolacrimal duct cyst (CNLDC) is a rare neonatal condition that can be life threatening when it occurs bilaterally. Herein we report a neonate with bilateral CNLDC that caused respiratory distress and was treated successfully with surgery. Post surgery, the patient was discharged from hospital without any complications. The case details, differential diagnosis, and management of CNLDC are discussed, along with a review of the relevant literature. © 2014 Elsevier Ireland Ltd.