The breadth of pathology within the scope of ocular oncology spans all ocular, orbital, and adnexal structures. As such, the clinical assessment of patients must be accordingly comprehensive and tailored for the detection and surveillance of neoplastic processes. While the essential modalities of standard ophthalmic examination are utilized in the practice of ocular oncology, a nuanced perspective is necessary to optimize management for this subset of patients. In this chapter, we present the systematic approach to clinical examination employed at The New York Eye Cancer Center as a basis for the assessment of patients in ophthalmic oncology practice.