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Purpose To provide an Arabic translated, cross-culturally adapted version of the Lacrimal System Questionnaire (Lac-Q) and to validate the translated version. Materials and methods Arabic translation of the Lac-Q passed four stages: forward translation of the original English version to Arabic, backward translation to English, comparison of the original and the backward translated versions, and then a final review of the created Arabic version by an expert committee. Revalidation involved asking each participant after signing an informed consent to complete the Arabic version of the Lac-Q preoperatively, 6 and 12 weeks postoperatively. The surgical success was assessed 12 weeks postoperatively by Jones test 1 and by asking the patients to complete a satisfaction form with the surgical outcome. The patient reported being ‘satisfied’ or ‘not satisfied’ according to the improvement of the symptoms and if he/she believed further treatment was required. Results The Arabic version of the questionnaire was completed by 39 patients, where 11 of them had bilateral surgery done in the same sitting. We found a statistically significant positive correlation between patients’ social and eye symptom scores (preoperatively and 6 and 12 weeks postoperatively). Good internal consistency and test–retest reliability were confirmed by calculated Cronbach’s alpha and intraclass correlation coefficient, respectively. In addition, good discriminative validity was confirmed by a statistically significant difference between the scores of the diseased eye before the surgery and the eyes treated surgically. The score difference between the patients with successful and failed surgeries was statistically significant confirming good responsiveness of the studied version. Conclusion The Arabic version of the Lac-Q is a valuable tool to assess the lacrimal symptoms.