Orbital lesions provide the physician with many challenges both diagnostic and therapeutic. These lesions comprise a wide variety of pathology. They cause a mass effect within the confines of an incompressible cavity and lead to displacement of eyeball and orbital contents. The wide variety of pathology and the limited clinical presentation makes the diagnosis of orbital lesions difficult. Recent diagnostic and technical innovations and anatomic observations have combined to make orbital surgery as precise as the most delicate ocular or brain surgery, in this work, the management of orbital & cranio-orbital lesions will be discussed regarding different etiologies, pathology, presentation, diagnosis and imaging, and different modalities of management. The results of surgery are evaluated together with post operative complications.