Twenty patients with a total of 22 chalazia unresponsive to conservative medical treatment were randomized for treatment with either intralesional triamcinolone acetonide or placebo. Eight of 12 lesions treated with triamcinolone acetonide resolved. In all ten of those treated with normal saline injection, treatment failed to achieve a clinical cure. Nine of the normal saline treatment failures were then injected with triamcinolone acetonide. Eight of nine in this group achieved clinical resolution. When the two treatment groups were combined, a total of 16 of 21 chalazia (76%) resolved with intralesional steroid therapy. Intralesional steroid therapy can be used successfully to treat chalazia, and its effect is not merely due to a mechanical disruption of the lesion. Pain and discomfort from intralesional injections is a common complaint.