Abstract
Rhabdomyosarcoma (RMS) is a rare and aggressive soft tissue malignancy primarily affecting children and adolescents. Orbital involvement is an uncommon presentation, particularly in young adults. In this case, we present a 21-year-old male with a history of childhood leukaemia treated with chemotherapy and bone marrow transplantation, who presented with a rapidly growing medial orbital mass subsequently diagnosed as RMS. The case emphasises the difficulties in diagnosing the condition, the value of early imaging and biopsy, and the complexities in managing orbital RMS in a patient with a significant oncological history.