Background: There has been increasing interest in Demodex and its association with conditions such as rosacea, blepharitis, chalazion, meibomitis and keratoconjunctivitis; and ivermectin as a treatment has been reported both in dermatology and ophthalmology.Objective: To review the literature in order to determine the role of Demodex in ocular surface inflammation and the use of ivermectin for its treatment.Study design: Review of the literature.Methods: An article search was done in PubMed with the following terms: Demodex, ocular rosacea, chalazion, pediatric rosacea, meibomitis, keratoconjunctivitis and ivermectin.Results: A review including the epidemiology and pathophysiology of ocular inflammation associated with Demodex is presented.Current knowledge on Demodex and rosacea, chalazion, blepharitis, meibomitis, keratoconjunctivitis and ocular rosacea is summarized.Relevant articles on the use of ivermectin for these conditions are listed.Conclusions: Recent evidence suggests Demodex is a trigger for a number of ocular surface inflammatory conditions.Although more studies are necessary to determine the effectiveness of topical ivermectin, current knowledge supports its acaricidal action against Demodex.