<b>Context</b> The effect on survival of orbital evisceration on patients with paranasal sinus neoplasms has not been well established. <b>Objective</b> To review systematically the available literature concerning survival in patients who undergo surgery for paranasal sinus neoplasm with and without preservation of the eye. <b>Data Source</b> A retrospective meta-analysis of English and non-English articles using Medline and the Cochrane database. <b>Eligibility Criteria</b> Studies analyzing 5-year survival rates in patients who had orbital evisceration compared with orbital preservation for the treatment of paranasal sinus neoplasms were included in the final analysis. <b>Data Extraction</b> Independent review by two authors using predefined data fields. <b>Data Synthesis</b> A meta-analysis of four articles involving 443 patients was performed using the DerSimonian-Laird random-effects method. <b>Results</b> Our analysis revealed a total effect size of 0.964 in favor of preservation of the eye; however, these results are not robust, having a true effect size anywhere from 0.785 to 1.142 with a 95% confidence interval. <b>Limitations</b> Only retrospective observational studies were included because a prospective randomized study cannot be performed in this population. <b>Conclusion</b> Our study supports the notion that in select patients preservation of the eye may yield a different outcome when compared with orbital evisceration.