Conjunctival amyloidosis is a rare clinical entity. We herein reported in vivo confocal microscopic features of conjunctival amyloidosis and correlated the results with the histopathological findings. Histopathological examination of the biopsy specimen revealed acellular, amorphous, eosinophilic material in the substantia propria of the conjunctiva and positive staining with Congo red confirmed that the material was amyloid. Confocal microscopy with Heidelberg Retina Tomograph II Rostock Cornea Module showed hyporeflective material deposited in a lobular pattern in the substantia propria and around the blood vessels. The material seemed acellular and no inflammatory or dendriform cell accumulation was noted within or around the lesion. Further studies should be done to understand the confocal characteristics of the conjunctival diseases and find specific clues for the diagnosis. © Journal compilation © 2008 Royal Australian and New Zealand College of Ophthalmologists.