A 77-year-old man presented for evaluation of a recurrent right orbital hemangiopericytoma. It had been excised twice over the past 6 years. After the second resection, the tumor rapidly recurred and was insensitive to systemic chemotherapy, and the patient was thus referred to the authors' institution. The patient had proptosis, restricted ocular movement, and binocular diplopia on presentation. Orbital imaging confirmed a well-circumscribed right extraconal mass in the medial orbit. Preoperative radiation therapy was given, which reduced the tumor volume considerably and allowed a successful complete surgical excision of the mass.