Sclerosing orbital pseudotumor is a particular type of idiopathic inflammatory process, frequently located at the orbital apex. Both from clinical and from instrumental examination the diagnosis of these forms is difficult. The ineffectiveness of steroid treatment and the progressive visual loss in these patients favors surgical exploration. We report on 5 patients who underwent exploration yielding the diagnosis of sclerosing orbital pseudotumor. Surgery allowed correct histological diagnosis and improvement of ocular symptoms.