To analyze the intraoperative frozen section diagnosis of eyelid tumors with modified Mohs surgery. Methods: This was a retrospective case study. Forty-four patients who had surgical treatment for eyelid tumors with an intraoperative frozen section technique from September 2014 to May 2018 in Qingdao Eye Hospital were included in the study. The eyelid tumors and the margin of the tumors were sectioned for frozen section diagnosis. Results: In 44 cases of eyelid tumors, 43 had a confirmed diagnosis, and 31(70%) had malignant tumors, including basal cell carcinoma in 22 cases (50%), meibomian gland carcinoma in 5 cases (11%), squamous cell carcinoma in 2 cases (5%) and in situ carcinoma in 2 cases (5%). Twelve cases were diagnosed with benign lesions, including 5 cases of varus follicular keratosis, 3 cases of seborrheic keratosis, 2 cases of chronic inflammation, and 1 case of eyelid abscess and 1 case of amyloidosis. Only one case could not be confirmed during surgery, and metastatic renal cell carcinoma was confirmed by paraffin section. In malignant tumors, the suspected tumor cells in the margin of the resection were found in 3 cases, and extended resections were performed until no tumor cells could be found. Postoperative follow-up showed there was no recurrence of eyelid tumors in any patients. Conclusions: Intraoperative frozen section with surgical treatment can rapidly evaluate the malignancy of eyelid tumors and the margin of resection, which can help clinical surgeons choose the scope of surgical resection for precision surgery.