Purpose To review clinical causes for ocular enucleations and the histopathological features of the enucleated globes in a large third-referral centre in China. Methods The retrospective study included 1375 globes enucleated in the Beijing TongRen Hospital between January 2003 and November 2006. The medical records were reviewed, and the clinical indications for enucleation and histopathological findings were evaluated. Results The enucleated eyes accounted for 0.97% of all operated patients registered in the hospital and for 29.5% of all surgical specimens received in the pathological department. The age distribution showed two peaks at an age group of 0-10 years (main enucleation cause: retinoblastoma) and at an age group of 30-40 years (main cause: trauma). In the whole study group, trauma was the most common clinical diagnosis (62.5%) leading to enucleation, followed by tumours (28.5%), surgically treated or untreated ocular diseases (5.7%), and infectious or inflammatory diseases (1.7%). With respect to the histopathological findings, phthisis bulbi (36.4%) was the most frequent finding followed by ocular malignant tumours (28.5%), and acute severe ocular injury (19.9%). Uveal metastases were the second most common intraocular malignant tumour in adults, in the majority of globes secondary to a primary lung cancer. Conclusions The rate of 1% of enucleations per patient operated and the relatively high rate of ocular traumata as primary cause for enucleation suggest to improve further safety conditions and primary surgical care. The relatively high rate of ocular tumours as cause for enucleations suggests to promote the wide-spread clinical introduction chemoradioactive tumour therapy.