Context: A prospective epidemiological study of eyelid and adnexal lesions in the pediatric age group was carried out with an objective of studying distribution pattern based on age and gender and classify the diseases based on the site of lesion and etiology. Methods: This was an observational prospective study conducted amongst 649 cases in the age group of 0-18 years, presenting to the oculo-plastic clinic of Sarojini Devi Eye hospital conducted for duration of one year. All patients in the age group of 0 to 18 yrs presenting to the outpatient department are included and emergency cases where data could not be collected are excluded. All patients underwent a comprehensive eye examination and investigations specific to the type of disease. Results: Most patients belonged to the age group of 12-18 years. Involvement was unilateral in 84.74% and bilateral in 15.26%. Acquired lid lesions were 70.42% and congenital lesions 29.58