A retrospective study was undertaken to determine the relative incidence of all eyelid lesions (720 cases) submitted to the Wills ophthalmic pathology laboratory between July 1, 1980, and June 30, 1982. Data on age, sex, location, and diagnostic accuracy were also tabulated. One hundred twenty-five (17.4%) malignant lesions were found. The most common lesion of the eyelid was basal cell carcinoma, which represented 14.3% of the total and 82.4% of the malignant lesions. Differences between malignant and benign lesions were searched for. The data suggests that lesions occurring in the upper lid are much less likely to be malignant than those occurring elsewhere. Among the 125 malignant lesions, clinicians were 92.8% accurate in predicting malignancy.