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In this paper, we propose a variational approach to unsupervised sentiment analysis. Instead of using ground truth provided by domain experts, we use target-opinion word pairs as a supervision signal. For example, in a document snippet "the room is big," (room, big) is a target-opinion word pair. These word pairs can be extracted by using dependency parsers and simple rules. Our objective function is to predict an opinion word given a target word while our ultimate goal is to learn a sentiment classifier. By introducing a latent variable, i.e., the sentiment polarity, to the objective function, we can inject the sentiment classifier to the objective function via the evidence lower bound. We can learn a sentiment classifier by optimizing the lower bound. We also impose sophisticated constraints on opinion words as regularization which encourages that if two documents have similar (dissimilar) opinion words, the sentiment classifiers should produce similar (different) probability distribution. We apply our method to sentiment analysis on customer reviews and clinical narratives. The experiment results show our method can outperform unsupervised baselines in sentiment analysis task on both domains, and our method obtains comparable results to the supervised method with hundreds of labels per aspect in customer reviews domain, and obtains comparable results to supervised methods in clinical narratives domain.