To discuss the role of upper fornix conjoint fascial sheath suspension and levator palpebrae superioris shortening in patients with severe blepharoptosis. Methods A total of 50 patients with severe blepharoptosis diagnosed and treated in our hospital from April 2022 to April 2023 were randomly divided into group A and group B, with 25 patients in each group. Group A was treated with frontal muscle suspension, and group B was treated with conjoint fascial sheath suspension and levator palpebrae superioris shortening. The correction effect, complications, improvement of quality of life and appearance satisfaction were compared between the two groups. Results The moderate correction rate of group B was 96.00%, which was higher than 64.00% of group A (P <0.05). The incidence of postoperative complications in group B was 4.00%, which was lower than 24.00% in group A (P <0.05). After treatment, the scores of sleep, self-care ability, appetite, pain and spirit in group B were lower than those in group A (P <0.05). The appearance satisfaction of group B was 92.00%, which was higher than 64.00% of group A (P <0.05). Conclusion Upper fornix conjoint fascial sheath suspension and levator palpebrae superioris shortening can improve the correction effect of patients with severe blepharoptosis, reduce the risk of postoperative complications, further improve the quality of life of patients after surgery, and patients have a higher degree of satisfaction with the postoperative appearance.