Aim of Work: To review the clinical and pathologic features, treatment and outcomes of primary carcinoma of eyelids and periorbital skin. In this prospective study seventy six patients with primary carcinomas of the eye lids and the periorbital skin were treated between January 2009 and December 2014. The analyzed epidemiologic data and clinical pathologic criteria of all lesions. General anesthesia was used for all patients and frozen section examinations were done only in eye lids and inner canthus lesions, the cutaneous margin including the resected parts of the lid margins and the deep soft tissue margin were confirmed negative intraoperatively. The follow-up period ranged from 8 month to 5 years. We recorded and analyzed the surgical complications and their management, the functional and cosmetic results in addition to the recurrence rate. Exclusions criteria includes recurrent cases and those with familial cancer syndromes. Results: Male to female ratio was (1.7:1). Age of the patients ranged from 36 to 81 years with an average incidence of 66 years. BCC represented 93.5% of the lesions (71 patients), SCC represented 5% of the lesions (4 patients) and mebomian gland carcinoma of upper eye lid occurred in one patient (1.5%). The most common clinical variant of BCC was the nodular type and maximum diameter of the lesions ranged from 4mm to 24 mm. Inner canthus was the most common location for BCC, followed by the outer canthus. SCC occurred only in the lids and in 4 patients only. Two of them were treated by orbital exenteration, one by wide local excision and median glabellar flap and the fourth by excision and primary closure. The patient with mebomian gland carcinoma was treated by subtotal upper lid excision and lid switch flap for lid reconstruction in addition to cervico-facial lymphadenectomy. All safety margins were confirmed negative in the paraffin sections. The most common method of repair was primary closure done in 35 patient (47%) followed by paramedian glabellar flap in 33 patients (43%). The rate of postoperative complications was 23.5% (18 patients) and the recurrence rate was 1.3% (1 patient only). Conclusion: Primary cutaneous carcinoma of the periorbital region is a curable disease and most of the patients present early in the disease course. Negative margins are easily obtained with conventional frozen section techniques but local recurrences still can occur. Functional complications are inevitable. Their correction is an integral part of surgical treatment. Keywords: Basal cell carcinoma (BCC), squamous cell carcinoma (SCC), periorbital skin, surgical treatment.