In this 2013 Oculofacial Plastic Surgery Subspecialty Day presentation, Dr. Matthew Wilson outlines the evaluation and management of pediatric patients with suspected orbital malignancies, especially sarcomas. Though exceedingly rare, rhabdomyosarcoma is the most common orbital malignancy in children. He explains how to distinguish this tumor from non-rhabdomyosarcomas, and reviews outcomes from the Intergroup Rhabdomyosarcoma Study Group (IRSG) that have improved survival rates over the past 40 years.