A 22-year-old man with a recurrent intraconal cystic mass of the orbit presented with proptosis, motility restriction, and optic disc edema. On initial surgery, the cyst wall showed nonkeratinized cuboidal epithelium with adnexal structures. After recurrence, repeat histopathologic evaluation again showed nonkeratinizing conjunctival epithelium with goblet cells. The diagnosis was consistent with a dermoid cyst of conjunctival origin. Our review of the literature found 29 previous cases in the literature. Unlike typical cutaneous dermoids, conjunctival dermoids occur in young adults and are usually located in the nasal or superonasal deep orbit. The location and adnexal structures associated with these lesions suggests derivation from embryonic epithelium destined to become caruncle.