Abstract: Objective To study the technique of XL-radiofrequency ablation skin apparatus in micro-resection of lacrimal caruncle neoplasm and observe its clinical effects. Methods Under the helmet-like microscope, XL-radiofrequency ablation skin apparatus was applied to 10 patients (6 males and 4 females with age of 14-52 years old) with lacrimal caruncle neoplasm in our hospital from October 2011 to November 2017 by point separating and layer removing technique till the neoplasms was completely removed.There were 5 cases with intradermal nevus, 1 case with mixed nevus, 1 case with mixed nevus and inflammatory granuloma, 1 case with sebaceous cyst, and 1 case with squamous papillary cell tumor. Of the 10 cases, eight cases had functional epiphora and 2 cases had divided lid nevi. The postoperative follow-up durations ranged from 6 to 72 months. Results All neoplasms were resected successfully in a single operation with well healing, no recurrence, dryness, vision loss, scarring, palpebral margin deformity, conjunctival scar healing or adhesion was found. In addition, the patients with functional epiphore were completely healed. Conclusion Micro-resecting of lacrimal caruncle neoplasm using XL-radiofrequency ablation skin apparatus has several advantages such as higher accuracy, scarlessness, less pain, less complication and quicker recovery.