Objective: To report the case of a 48-year-old African American man with lentigo maligna of the left lower eyelid. Design: Interventional case report. Participants: One patient with lentigo maligna of the left lower eyelid. Methods: We report the clinical presentation, histopathologic and immunohistochemical features, and treatment of an African American man with lentigo maligna of the eyelid. The current literature regarding this uncommon neoplasm in African American patients also is reviewed. Main Outcome Measures: Histopathologic and immunohistochemical diagnosis and clinical evaluation for recurrence. Results: An excisional biopsy revealed lentigo maligna. An extensive literature search revealed no definitive reports of lentigo maligna or lentigo maligna melanoma of the eyelid in an African American patient. Conclusions: Although extremely rare, lentigo maligna may involve ocular adnexal skin in African Americans. Awareness and recognition of this premalignant lesion will aid in early diagnosis and treatment and eventually may improve prognosis.