Four cases of conjunctival pyogenic granuloma are described. The patients ranged in age from 12-30 years. Surgical trauma preceded the development of two lesions in one patient and a second patient presented with a positive history of recurrent styes, a chalazion, and a questionable history of trauma to the lid. The other two patients had no known antecedent events that would explain development of the lesions. A review of the literature is included in the discussion, which details the etiology, incidence, clinical presentation, histopathology, symptoms, clinical course, differential diagnosis, and treatment of pyogenic granulomas.