We reviewed 57 consecutive biopsies of lesions of the caruncle seen in the Wills Eye Hospital Pathology Department from 1977 through 1985. The types and relative frequency of excised caruncular lesions were recorded and correlation of pathologic diagnosis with preoperative clinical diagnosis, age, and sex was made. Squamous papillomas accounted for 18 (32%) and nevi for 14 (24%) of all caruncular masses. Pyogenic granulomas accounted for five (9%), epithelial inclusion cysts for four (7%), chronic inflammation for four (7%), and oncocytomas for two (4%) of all caruncular masses. Of the 57 cases only three (5%) were malignant tumors.