Basal cell carcinoma is a common skin cancer affecting the eyelid, typically treated with surgery or radiotherapy. However, these methods can cause visible scarring or may not be suitable for some patients. This systematic review evaluated the use of imiquimod five percent cream as a non-invasive treatment option. The findings showed that the cream was effective in eliminating tumors in most cases, especially when the lesions were small and superficial. Patients generally experienced mild-to-moderate skin irritation around the eye, such as redness or crusting, but serious complications were not reported. Cosmetic outcomes were often better than those seen with surgery or radiation, with minimal scarring and preserved eyelid function. This treatment may be particularly helpful for individuals who are not good candidates for surgery or who prioritize appearance. The results support the use of imiquimod in selected cases and highlight the need for further studies on long-term outcomes and optimal treatment regimens.