Objective To investigate the clinical effect of shortening of levator palpebrae superioris combined with partial sacral resection in patients with moderate to severe blepharoptosis. Methods A total of 90 patients with moderate to severe blepharoptosis admitted to our hospital from November 2019 to November 2022 were selected as the research objects. They were divided into control group and study group by random number table method, with 45 cases in each group. The control group underwent frontal muscle flap suspension, and the study group underwent shortening of levator palpebrae superioris combined with partial sacral resection. The clinical efficacy, ocular surface indexes [tear secretion test (SIt), tear film rupture time (BUT), corneal fluorescein staining (FL)], complications and correction satisfaction were compared between the two groups. Results The total effective rate of treatment in the study group was 97.78%, which was higher than 82.22% in the control group (P <0.05). The BUT of the study group was shorter than that of the control group at 1 month after operation (P <0.05). There was no significant difference in SIt and FL between the two groups (P >0.05). The incidence of complications in the study group was 6.67%, which was lower than 22.22% in the control group (P <0.05). The correction satisfaction of the study group was 95.56%, which was higher than 80.00% of the control group (P <0.05). Conclusion The application of shortening of levator palpebrae superioris combined with partial sacral resection in patients with moderate to severe blepharoptosis is effective, which can effectively alleviate the blepharoptosis of patients and improve the ocular surface index. Meanwhile, it has fewer postoperative complications and higher safety, which is conducive to improving the satisfaction of correction and is worthy of clinical application.