BlepharoptosisBlepharoptosis repair via an anterior approach is commonly preferred for the ability to treat more profound blepharoptosisBlepharoptosis and because skin and fat excess can be treated concomitantly. From an anterior surgical approach, the levator aponeurosis can be advanced or resected to elevate the eyelid. Muscle disinsertion causes aponeurotic ptosisAponeurotic ptosis. External levator advancementExternal levator advancement is primarily reserved for aponeurotic ptosisAponeurotic ptosis, in the setting of normal levator function and includes re-approximation of the dehisced levator muscle to the tarsus. In levator resectionLevator resection, the muscle is reinserted followed by removal of the excess levator tissue. In this chapter, the authors detail principles and techniques of anterior approach to blepharoptosisBlepharoptosis.