The medial canthus, with its many important structures, is often the site of tumors. After excision of tumors from this area, or with large defects here from other causes, reconstruction by conventional plastic techniques not only often is difficult, but frequently gives poor functional and cosmetic results. A technique of repair of such defects by spontaneous granulation with minimal plastic repair has previously been reported. A review of 20 cases treated in this manner showed excellent results in 15 cases and only one result that was less than good cosmetically. In the four cases with complications requiring further treatment, the complications were caused principally by excess scar formation and were readily amenable to surgical correction with good to excellent results in all cases. Further repair was believed to be indicated by the surgeon but not by the patient in one case. In the 19 cases repaired in this manner after tumor excision, there were no recurrences in follow-up of up to seven years. When indicated, spontaneous granulation seems to be an excellent method of medial canthal repair, often better than repair by conventional plastic techniques.