Xanthelesma frequently occur around the eyelids. They appear as yellowish plaque like lesions on the medial aspect of the upper or lower eyelids. These plaques consist of foam cell deposits which contain lipid substance. When the lesion is small, direct excision and closure is the treatment of choice. However when the lesions are large and confluent, serial excision and sometimes skin grafting may be required. There is a small significant risk of recurrence (about 10%) because they may have subcutaneous extension.