Malignant orbital tumors in children include primary, secondary, and metastatic tumors. Rhabdomyosarcoma is the most common primary malignant orbital tumor in the pediatric age group. Retinoblastoma is the most frequent secondary orbital tumor in this age group. Orbital metastases in children are usually rare. The most frequent metastatic orbital tumor in children is neuroblastoma. A review of 1264 orbital lesions over a 30 year period from Wills Eye Hospital disclosed that malignant orbital lesions accounted for approximately 20% of all space-occupying orbital lesions in children in a combined clinical and histopathologic series. In another review of 340 orbital tumors in children during a 60 year period from the Mayo Clinic, malignant orbital tumors accounted for 18% of all histopathologically proven orbital lesions. Rhabdomyosarcoma was the most frequent orbital malignancy followed by retinoblastoma, lymphoma, and neuroblastoma. In developing countries, secondary orbital invasion from retinoblastoma is usually the predominant malignant orbital tumor in children.