We report a case of Muller muscle intramuscular hemangioma in the upper eyelid mimicking dacryoadenitis.

A 21-year-old male patient presented with a 2-year history of upper eyelid swelling in his right eye and no symptom relief with oral corticosteroid. Increased angiotensin-converting enzyme (ACE) was noted in the laboratory findings. However, lid inflammation was not improved and the patient underwent incisional biopsy.

Microscopically, the lesion was composed of proliferating vessels of various sizes between the individual smooth muscle fibers. Intramuscular hemangioma rarely presenting as a benign tumor in the head and neck region can present as diffuse swelling mimicking sarcoidosis or dacryoadenitis.