OBJECTIVE: The aim of this study was to report the clinicopathological features of 18 epithelial tumors of the lacrimal gland treated in a single institution. STUDY DESIGN AND SETTING: Clinical data and treatment were recorded and histological features reviewed. RESULTS: Twelve tumors (66.7%) were adenoid cystic carcinoma (ACC), 5 (27.8%) pleomorphic adenoma (PA), and 1 (5.5%) carcinoma ex pleomorphic adenoma. All patients with ACC presented with advanced clinical stage, and most were treated by wide surgical resection followed by adjuvant radiotherapy. No recurrence was observed in 4 cases of ACC however, 7 patients died from persistence of disease or by local and/or distant recurrence. All PA patients were successfully treated by surgical resection. CONCLUSIONS: Epithelial lacrimal gland tumors are mainly PA and ACC, and malignancies are more common than benign tumors. Although ACC presented typically with advanced clinical stage, 33% of the patients survived without tumor recurrence or metastasis.