Background: Retroperitoneal malignancies are a rare group of cancers with an annual incidence of 2.7 cases per 1 million. Due to their rare occurrence, the understanding of these malignancies is very poor. The prominent oil industry in West Texas is a potential source for both occupational and environmental exposures of chemical carcinogens. We suspect that chemical exposures in the local environment have led to an increased incidence of retroperitoneal neoplasms in the local population. Method: We reviewed a retrospective departmental database to examine all retroperitoneal neoplasms diagnosed in long-term residents of the region over a 4 year period. Occupational and potential exposure histories were documented. Results: There were nine cases of retroperitoneal neoplasms identified over 4 years. This represents a 278% increase over the expected incidence of 3.24 cases per 4 years. Six of the nine patients either worked in the oilfields themselves or had spouses that did so. The remaining three patients may have had passive chemical exposure due to close proximity to oil drilling and production. Conclusion: Taking the two other regional hospitals that service the area and the multiple tertiary care centers outside of the region into account, the retroperitoneal malignancy incidence rate in West Texas is most likely even higher than reported in this study. We recommend a 20 year temporal correlation for retroperitoneal malignancies and oil manufacturing, as well as any other malignancies that might be associated.