Thirty-five patients with orbital and eyelid lesions were subjected to fine needle aspiration biopsy (FNAB). Histopathology or other investigations were available in 18 cases; in 17 cases (94%) a concordant diagnosis was reached. There was one false-positive diagnosis in 18 cases (5.5%). FNAB is a reliable and safe diagnostic technique and can be used routinely in outpatient departments for the diagnosis of orbital lesions. It is particularly useful in nonresectable and retrobulbar orbital lesions.