Conventional treatment options for periorbital syringomas are often unsatisfactory because of inevitable surface damages from the procedure and frequent recurrence rate of the tumors.To ascertain the efficacy and safety of intralesional electrosurgery using a monopolar radiofrequency device with a single insulated microneedle for the treatment of periorbital syringomas.A retrospective analysis was performed using data from medical records, routine questionnaires, and clinical photographs of 55 patients with periorbital syringoma who underwent intralesional electrosurgery.Approximately half of the patients (50.9%) experienced marked resolution after one treatment. The lesion clearance rate increased and lesion severity decreased each time the treatment was repeated. No persistent therapy-related adverse event was found except transient erythema or crusting.Intralesional electrosurgery with insulated microneedle is an effective and safe treatment option for periorbital syringomas.