Purpose <p>To evaluate the efficacy and safety of autologous labial mucosal grafting for cicatricial entropion, with emphasis on visual outcomes, eyelid correction, symblepharon severity, and complications.</p> Methods <p>A retrospective analysis was performed on 29 patients (38 eyes) who underwent autologous labial mucosal grafting between March 2019 and January 2025. Preoperative and postoperative best-corrected visual acuity, eyelid position (graded 0–4), symblepharon severity (graded 0–3), and complications were compared.</p> Results <p>All surgeries were completed without severe intraoperative or postoperative complications, and grafts survived well without contraction or necrosis. Overall, best-corrected visual acuity showed no significant change after surgery (<i>P</i> = 0.545). By etiology, the burn-induced group showed a nonsignificant trend toward improvement, whereas the immune-mediated group remained stable. Both entropion and symblepharon scores improved significantly postoperatively (<i>P</i> &lt; 0.05). Subgroup analysis showed greater benefits in burn-related cases compared with immune-mediated etiologies, particularly after a single procedure (<i>P</i> &lt; 0.01). Multiple surgeries conferred no additional benefit. Patients with longer disease duration (≥ 40 months) tended toward better entropion correction, though this did not reach statistical significance (<i>P</i> = 0.097).</p> Conclusions <p>Autologous labial mucosal grafting effectively restores eyelid structure and function in moderate to severe cicatricial entropion, especially after chemical or thermal burns. With low complication and recurrence rates, it is a safe and reliable option. Larger prospective studies are warranted to confirm long-term outcomes.</p>