A case of Meibomian carcinoma of the left eyelid was observed in a 53-year-old-female patient. SHe had been previously treated for chronic unilateral blepharoconjunctivitis; an excisional biopsy disclosed a Meibomian carcinoma. First a total resection of both left eyelids was performed with plastic reconstructive surgery, three months later a recurrence required an orbital exenteration. This case underlines the interest of an early diagnosis which allows a more conservative treatment. The diagnosis must be kept in mind in any case of chronic unilateral blepharoconjunctivitis; histopathology has a key role in the diagnosis of Meibomian carcinoma.