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Purpose : The current study was undertaken to determine the frequency of specific primary conjunctival neoplastic lesions in a patient population treated at an ocular service over a 15-year period. Materials and Methods : We analyzed the data of all primary cases of conjunctival neoplasia diagnosed from 1990 to 2004 in the pathology department of Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Results : Of 3,242 conjunctival specimens, 447 were identified as primary conjunctival neoplasms. The patient group comprised 270 (60.4%) males and 177 (39.6%) females, with an age range of 1 to 90 years. The mean age was 38 years and the median was 32 years. The most common primary conjunctival neoplastic lesion was nevus (38.7%), followed by squamous cell carcinoma, (25.1%), papilloma (7.8%), dysplasia (5.6%), and hemangioma (5.1%), respectively. Of 447 lesions, 261 (58.4%) were benign, 134 (30%) were malignant, and 52 (11.6%) were precancerous. Conclusion : As in previously published studies, benign lesions were the most frequent, but the percent of malignant lesions was much higher than that described in other reports. The high percentage of squamous cell carcinoma that we observed can likely be attributed to elevated sun exposure and ultraviolet light in Iran. The characterization of precancerous lesions in this study emphasizes their potential to transform into malignant lesions and the need for sufficient early management and follow up. [ABSTRACT FROM AUTHOR]