Basal cell carcinoma (BCC) is the most common malignant neoplasm of the skin, and in the eyelids it accounts for about 80-85% of all malignant cutaneous tumors. It occurs more commonly in fair-skinned adults, with a peak incidence between the 5th to the 8th decades of life. Nodular BCC presents as an indolent, firm, indurated, elevated lesion with smooth rolled, pearly, shiny borders and fine telangiectasias around the borders. Central ulceration is a common finding and pigmentation can be seen as a rare variant. The morpheaform or sclerosing subtype is more aggressive, and presents as an infiltrative locally destructive lesion with ill-defined margins. Treatment is primarily with wide surgical excision with clear margins, but targeted inhibition of the sonic hedgehog pathway now offers a promising treatment option in selected patients