A sarcoid-like reaction is the presence of noncaseating granulomas due to a T-cell mediated inflammatory reaction in draining lymph nodes of tumors or in the vicinity of tumors. Breast cancer, lymphoma, and cutaneous melanoma have been observed to induce a sarcoid-like reaction. Herein, a patient is reported with conjunctival melanoma in whom multiple noncaseating granulomas were observed in the sentinel lymph node without evidence of micrometastasis. Fungal and mycobacterium stainings were negative and further systemic workup excluded sarcoidosis. This case identifies conjunctival melanoma as a cause of a sarcoid-like reaction.