The authors present three cases of periorbital extranodal natural killer / T cell lymphoma (ENKL). Ages were 20, 45 and 55. All of these patients presented with painless eyelid swelling and a history of sinus disease. One patient had persistent bilateral panuveitis, two had extraocular muscle involvement. Initial biopsies were negative in two of the patients with repeat biopsy confirming lymphoma. The patients died at five, nine and 35 months after diagnosis despite treatment with radiotherapy and chemotherapy. The article highlights the rare presentation of ENKL to the ophthalmologist. An index of suspicion should be maintained in atypical cases of ‘orbital cellulitis’.