Medial eyelid defects often damage the lacrimal drainage system, and reconstruction for these patients is challenging. The purpose of this report is to describe a new surgical technique for canalicular reconstruction using canalicular transposition. A 67-year-old female patient presented with an eyelid tumor diagnosed as a sebaceous cell carcinoma at the medial left lower eyelid. The tumor along with the lacrimal punctum and canaliculus was excised. The remnant of the canaliculus was transpositioned to the eyelid margin, and the eyelid was reconstructed by direct closure with cantholysis. Transpositioned canaliculus was patent and functioned well at 1-year postoperative follow-up. A novel technique of reconstruction of medial eyelid defect involving the lacrimal drainage system is described.