Purpose: To describe a case report of the successful management of necrobiotic xanthogranuloma (NXG). a rare periorbital disease. Observations: A 61-year-old patient presented with bilateral upper and lower lid lesions which were initially misdiagnosed as xanthelasmas and later confirmed to be NXG. Further investigation also uncovered a diagnosis of multiple myeloma. https://miamistares.shop/product-category/mud-flap-products/