Eyelid lesions are common concerns amongst patients. Internists, family practitioners, dermatologists, and ophthalmologists are often requested to determine if a lesion is benign or malignant. Histopathological diagnosis and clinical correlation have been studied in published case reviews. Studies overseas have also examined the incidence in specific populations.1-3,6,7 Benign tumors greatly outnumber malignant tumors.1-5 Basal cell carcinoma has been shown to have the highest incidence among malignancies. 8 Lin et al. described a significantly higher incidence of sebaceous gland cell carcinoma in Taiwan. In this case series review, the authors examined the incidence and histopathology of eyelid tumors in an American urban medical center with a diverse patient population. Eyelid tumor pathology data were gathered from the California Pacific Medical Center in San Francisco, California, from 2004 to 2007. The authors had full access to all data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. While previous studies regarding eyelid tumors have relied on national tumor registries in various countries and regions within the United States, this study focused solely on eyelid tumors at a specific hospital in an urban setting with a known diverse population.