Aims <p>The aim of this study is to describe the outcomes of OSSN management at a tertiary eye hospital in Johannesburg, South Africa.</p> Methods <p>This was a prospective interventional study, which included patients presenting with conjunctival masses at a tertiary eye hospital from December 2019 to February 2022. An electronic questionnaire was completed to document demographic data, presenting history, and associated risk factors. All patients had a biopsy to confirm the diagnosis. Tumours that occupied less than or equal to 4 limbal clock hours had an excision biopsy. Larger tumours had an incision biopsy followed by topical 5-fluorouracil (5FU) as primary management. Recurrences and positive margins were managed with 5FU. Patients were followed up for 2 years to monitor for recurrence.</p> Results <p>One hundred and nine patients with 114 conjunctival masses were included in this study. Ninety-four percent (107/114) of patients had an excision biopsy as their primary management, with a recurrence rate of 0.9% (1/107). Seven patients had 5FU as primary therapy with a complete resolution rate of 71% (5/7) and a recurrence rate of 14% (1/7).</p> Conclusion <p>A standardised management approach for OSSN based on the size of the tumour resulted in high resolution rates and a low rate of recurrence.</p>