Osteoma is a benign, slow-growing tumor, which mainly occurs in the bones and cavities of the middle third of the face, representing the most frequent benign tumor of the paranasal sinuses. Osteoma of the paranasal sinuses is generally asymptomatic and it is discovered only as a coincidental radiological finding; when it becomes symptomatic, the most common presenting symptoms are headaches and facial pain. Rarely the sinusal osteoma may entail secondary orbital extension, with ocular signs and symptoms. Primary intraorbital involvement is extremely rare. The authors present a review of the literature and report two cases of primary orbital osteoma. In both cases surgical treatment led to the complete remission of symptoms. Diagnosis and surgical therapy are discussed.