Sebaceous adenocarcinoma is a rare neoplasm of the eyelid that often masquerades as a chalazion, blepharitis, or blepharoconjunctivitis. Controversy exists as to the proper mode of therapy for patients with a tumor confined to the eyelid. We believe that wide local excision (5 to 6 mm of normal tissue) with frozen section analysis and eyelid reconstruction is the preferred treatment. Only 1 of 11 patients had a recurrence with this technique. No regional or distant metastasis has occurred in an average of 68 months of follow-up.