Malignant tumors of the eyelid pose a serious threat because of their proximity to the globe, brain, and paranasal sinuses. We review the features of four common skin carcinomas involving the eyelid skin. Particular emphasis is given to their clinical presentation and to biologic behavior. Clinicians are encouraged to be aware of the clinical manifestations of these tumors, since early recognition and treatment result in the most cosmetically and functionally satisfactory results. An approach for rational treatment is presented.