Purpose: Nevus comedonicus is a rare developmental abnormality of the infundibulum of the hair follicle. Observation: We report here an unusual case of bilateral extensive nevus comedonicus of the eyelids complicated by bilateral ptosis and ectropion of the lower eyelids. Blepharoplasty was performed on both upper eyelids. Histopathological findings on skin biopsy typically show large, grouped, dilated follicular ostia filled with keratin. Conclusions and importance: This case is unusual as regards the late-onset (lesions first appeared at age 35) and location of the nevus comedonicus on both eyelids. Keywords: Nevus comedonicus, Ptosis, Ectropion