SUMMARY The authors have reviewed 15 cases of orbital dermoids representing 6% of orbital tumours seen at the University of British Columbia Orbital Clinic. They tended to occur as either asymptomatic superficial lesions in children or as complicated deep lesions in adolescents and adults. The superficial lesions were as frequent medially as laterally and could be dealt with by a direct uncomplicated surgical approach. The deep lesions in contrast, were frequently extensive and difficult to remove, requiring careful preoperative planning. Sites of origin, presentation, differential diagnosis, and management are discussed.Dermoid cysts occur in the orbital and periorbital region presenting in a variety of ways depending upon the site of origin, size, and rapidity of growth. The frequency ofoccurrence varies with the age group being studied. 1-3 and the particular interest of the centre. In the University of British Columbia orbital clinic we have noted a range of presentations from benign, isolated masses, to complicated and frequently misdiagnosed recurrent tumours with and without fistulisation. From our experience there appear to be two types of dermoid cysts seen in clinical practice. One presents as a simple or localised lesion and the other as a complicated one. The difference is based on the site of origin, location within the orbit, and the histological structure of the dermoid. Materials and methodsWe have reviewed all cases of histologically concomputed tomography, plain and tomographic xrays, and ultrasound.Surgical approaches included two lateral, nine anterior, one combined orbitotomy, and one excision from the temporal fossa, the approach depending on preoperative localisation. At the time of surgery the site of origin was explored and identified when possible. Postoperatively tumours were submitted for routine pathological study. Follow-up