Sentinel lymph node (SLN) biopsy has emerged as a technique for accurate staging of solid tumors. This technique permits the detection of microscopic metastases in clinically negative regional lymph nodes and may be indicated for malignancies that have a propensity for regional nodal metastasis. With the exception of basal cell carcinoma, almost all malignancies of the eyelid and conjunctiva metastasize to regional lymph nodes as the site of first metastasis. The histologic status of the SLNs has been shown to be the most significant prognostic factor with respect to recurrence and survival in patients with cutaneous melanoma. The indications for and the feasibility of SLN biopsy for eyelid and conjunctival tumors and our experience with this technique are reviewed.