Mucoepidermoid carcinoma of the orbit is an uncommon neoplasm. We report a 62-year-old Taiwanese man developed a painless proptosis for 8 years. He underwent tumor resection. By histopathology, mucoepidermoid carcinoma was diagnosed. Owing to the rare incidence, the role of adjuvant radiotherapy (RT) in the disease control has not been defined. Several episodes of recurrence developed despite repeated surgery in this case. The patient was treated with the adjuvant TomoTherapy afterwards. The results at 2 years image follow up revealed stationary tumor volume state after treatment. Therefore, adjuvant RT could be an option of treatment for recurrent mucoepidermoid carcinoma arising from the eye following surgery. Treatment decision making of this case is discussed and previous reports are reviewed in this article.