Idiopathic granulomatous disease was the cause of bilateral eyelid masses and additional ocular adnexal disease in a dog. Histologically similar granulomas developed concurrently in distant sites including the limbs, prepuce, and testicles. Periodic resolution and redevelopment of the masses were observed and were unaffected by corticosteroid treatments. Rapid diminution of some of the masses was found after treatment with polyethylene glycol modified L-asparaginase, but poor client compliance and episodes of spontaneous resolution of some of the masses made it difficult to accurately assess effectiveness of treatment. Clinicians should be aware that ocular adnexal granulomas may simulate neoplasms and be a component of a more widespread disease process.