Background: Mucoepidermoid carcinoma (MEC), sometimes referred to as adenosquamous carcinoma (ASC), is a common malignant tumor of the salivary glands that can also develop from the esophagus, lacrimal passages, lung, upper respiratory tract, pancreas, prostate and thyroid. Rarely, MEC will present primarily in the skin. Case: We present a case of primary MEC of the lower eyelid treated successfully with Mohs micrographic surgery. Results: Mohs micrographic surgery was performed because of the highly aggressive and unpredictable nature of this tumor. The tumor was completely excised using Mohs with negative margins achieved in three stages. The patient has been disease free for 3 years since the surgery. Conclusion: We offer Mohs as an option for treating MEC.
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