This is a retrospective review looking at levels of CD73 in aggressive basal cell carcinomas (BCCs) that invade the orbit. Eleven patients who underwent orbital exenteration for invasion by BCCs were compared with 10 matched controls who had simple nodular BCCs. All specimens were reprocessed and examined for the presence of CD73 positive cells. In the exenteration group there were on average 6.53 cells per x40 field, whereas the controls had 0.72 cells per x40 field (p=0.0002). CD73 has been found to be upregulated in a variety of other carcinomas and is associated with an increased risk of invasion, metastasis and mortality. The exact mechanisms behind this remain unclear but may involve a degree of T-cell suppression via increased adenosine levels. The numbers are small but the strong association between aggressive sub-types of BCC and CD73 positivity is interesting, and anti-CD73 antibodies are currently undergoing clinical trials.