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An 84-year-old female presented with multiple maggots crawling out of a large fungating left orbital mass. Computed tomography scan showed a heterogeneously enhancing mass arising from the left orbit surrounding the eyeball, displacing it laterally. Two days treatment with use of turpentine, betadine, hydrogen peroxide, and local removal was unsuccessful as the maggots would escape into depths of the orbit and crevices of the mass. A trial of 12 mg dose of ivermectin daily was given. After the first dose of the drug, the maggots were easier to remove manually. The orbit was maggot-free by the 2nd day. Ivermectin is of benefit in cases where conventional removal fails due to inaccessible worms. In view of its low cost and low side-effects profile, it can be explored as a first-line treatment along with manual removal.