400 orbital space occupying lesions encountered during a 30 year period were reviewed to determine the distribution of various pathologic processes and the trends over lime. Secondary and metastatic tumors were by far the most common (131 cases, 32.8%) followed by vascular lesions (61 cases, 15.2%), inflammatory lesions (53 cases, 13.2%) and cystic lesions (39 cases, 9.8%). In children (147 cases), the four most common space occupying orbital lesions were secondary and metastatic tumors (32 cases, 21.8%), rhabdomyosarcoma (24 cases, 16.3%), vascular lesions (21 cases, 14.3%) and inflammatory lesions (21 cases, 14.3%). The high frequency of secondary tumors were due to late presentation of many lid, conjunctival and ocular tumor cases. The distribution of the lesions in the first (1966-1980) and second half (1981-1996) were compared. The percentage of secondary and metastatic tumors fell from 48.5% in the first half to 27.6% in the second half. This difference seems to result from earlier recognition and treatment of primary neoplasms.