A retrospective review of cases of pyogenic granuloma seen at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia between 1984-1991 is described. Epidemiology and the factors that led to the granuloma formation were examined and only cases documented histopathologically were included in the review. Of the 110 cases, 80% developed the granuloma at the site of the previous surgery (especially entropion repair, and dacryocystorhinostomy with a stent tube or with a Jones tube) while 20% did not have a prior surgery. Recurrence occurred in 7% and these patients were in the group who had a prior surgery. Surgical procedures lead to an increased tendency for the formation of pyogenic granuloma due to different mechanisms acting via a mechanical or chemical irritation and an inhibition of re-epithelialization.