Aim: To evaluate the efficacy of cyclosporine A 0.05% emulsion for the treatment of dysfunctional tear syndrome. Methods: This randomised parallel prospective trial enrolled patients who had dysfunctional tear syndrome without lid margin with a severity level ≥2. Patients received unpreserved artificial tears in both eyes as needed and were randomised to receive adjunctive cyclosporine A 0.05% twice daily for 6 months in either the left or right eye. Patients were evaluated for signs and symptoms of dysfunctional tear syndrome at their first visit (baseline) and after receiving the study treatment at week 1 and months 1, 3, and 6. Results: Twenty two of 26 enrolled patients completed the study. Most patients were women (73%), and the median age was 49 years (range, 31 to 73 years). Compared with baseline, both treatments significantly improved signs and symptoms of dysfunctional tear syndrome at almost all follow-up visits (p < 0.05). Compared with artificial tears, eyes treated with cyclosporine A had significantly greater increases in tear break-up time and greater improvements in Schirmer I test scores (without anaesthesia), rose bengal staining, conjunctival injection severity, and the Modified Ocular Surface Disease Index at months 3 and 6 (p < 0.05). Schirmer II test scores and fluorescein staining scores were significantly improved in cyclosporine A-treated eyes compared with artificial tears - treated eyes at month 3 (p < 0.05). Conclusion: Concurrent treatment with cyclosporine A 0.05% emulsion and unpreserved artificial tears was effective for alleviating the signs and symptoms of dysfunctional tear syndrome.