We calculate the exact Casimir interaction energy between two perfectly conducting, very long, eccentric cylindrical shells using a mode summation technique. Several limiting cases of the exact formula for the Casimir energy corresponding to this configuration are studied both analytically and numerically. These include concentric cylinders, cylinder-plane, and eccentric cylinders, for small and large separations between the surfaces. For small separations we recover the proximity approximation, while for large separations we find a weak logarithmic decay of the Casimir interaction energy, typical of cylindrical geometries.