An eyelid nevus can be congenital (since birth) or acquired. The acquired nevus usually appears between the ages of five and 15 years, and remains relatively quiet for the remainder of the patient’s life. The eyelid nevus is painless and can be pigmented or nonpigmented, flat or elevated. Sometimes, there is a minimal (less than one percent) risk for nevus to grow into malignant melanoma so these lesions should be evaluated by an eye doctor. Management consists of cautious observation in many cases, versus complete surgical removal for more suspicious cases.