It is important that clinicians suspect malignancy in patients who have persistent or nonhealing periorbital lesions. Basal cell carcinoma, squamous cell carcinoma, and sebaceous gland carcinoma of the eyelids are frequently misdiagnosed clinically and, in the case of squamous cell and sebaceous gland carcinomas, histologically as well. Prompt and adequate biopsy can facilitate early diagnosis and thus avoid unnecessary metastatic spread in the case of squamous cell carcinoma and sebaceous gland carcinoma, as well as the extensive local destruction that basal cell carcinoma may produce.