A transconjunctival approach produced adequate biopsy specimens of the lacrimal gland in 24 of 27 patients with possible sarcoidosis. In five of the 24 noncaseating granuloma confirmed the diagnosis of sarcoidosis. Three of the five patients with enlarged lacrimal glands and four of the seven patients with increased lacrimal gland uptake of gallium had sarcoidosis confirmed by the biopsy. In carefully selected cases transconjunctival biopsy of the lacrimal gland should be considered an important part of the diagnostic evaluation of possible sarcoidosis.