To compare the effects of double eyelid surgery with orbital septum fixed incision and classical incision. Methods From January 2021 to December 2022, 60 patients who underwent double eyelid surgery in our hospital were selected as the research objects. According to the random number table method, they were divided into the conventional group and the observation group, with 30 patients in each group. The conventional group underwent double eyelid surgery with classical incision, and the observation group underwent double eyelid surgery with orbital septum fixed incision double eyelid surgery. The postoperative morphological improvement, complications and satisfaction were compared between the two groups. Results The total improvement rate of the observation group was 100.00%, which was higher than 66.67% of the conventional group (P <0.05). The incidence of complications in the observation group was 3.33%, which was lower than 20.00% in the conventional group (P <0.05). The satisfaction rate of the observation group was 96.67%, which was higher than 66.67% of the conventional group (P <0.05). Conclusion Double eyelid surgery with orbital septum fixed incision can effectively improve the postoperative double eyelid shape and improve the satisfaction of patients. It is a safe operation.