Objective　To evaluate the efficacy and safty of pegging hydroxyapatite orbital implants.Methods　Fourty-five patients who received drilling and pegging of hydroxyapatite orbital implants were studied retrospectively, and all patients used the peg and sleeve system followed-up 2 to 24 months.Results　The rate of success of the first operations is 82.2%. Complications associated with pegging included peg hole drilled on an angle, drilling off-center, drilled hole shallow, granuloma and infection, total complications occured in 22.2% in the review, most that are of a minor nature can be cured.Conclusions　The hydroxyapatite orbital implants can be directly coupled to the prosthesis through a peg system, allowing a wide range of prosthesis movement and giving a more lifelike quality to the prosthesis. When and how to drill and exactly hole on implant is the key for pegging.