Congenital conjunctival cysts often occur in the medial orbit without adjacent bone destruction and have not been previously reported in a dumbbell configuration. A 46-year-old female patient presented with left proptosis and headache. A radiological study revealed a large, cystic, bilobed mass in the orbital-temporal area with an osseous defect in the lateral wall. A histological examination of the excised lesion showed that the cyst wall consisted of nonkeratinized stratified epithelium with goblet cells. There was no recurrence during the follow-up. Of the previously reported 54 cases, only 1 had bone erosion due to a recurrent cyst in the frontal bone. Although rare, a primary conjunctival cyst can create a dumbbell-shaped lesion in the lateral orbit and temporal fossa.