Purpose <p>This study aims to investigate the clinical efficacy of an improved orbicularis oculi muscle plication surgery in treating senile involutional lower eyelid entropion.</p> Methods <p>A retrospective case–control study was conducted to compare the therapeutic effects, postoperative complications, and patient satisfaction between the improved orbicularis oculi muscle plication surgery and the traditional orbicularis oculi muscle shortening surgery.</p> Results <p>The results showed that the improved orbicularis oculi muscle plication surgery has significant advantages in treating senile involutional lower eyelid entropion, with fewer postoperative complications, better recovery of ocular symptoms, and good long-term effects.</p> Conclusion <p>The improved orbicularis oculi muscle plication surgery is simple and efficient.It is worth promoting and applying in primary hospitals.</p>