To analyze the effect of targeted systematic nursing on patients with ptosis surgery and its influence on postoperative eyelid aesthetic effect and appearance satisfaction. Methods A total of 86 patients with ptosis who underwent surgical treatment in our hospital from March 2021 to March 2023 were randomly divided into control group and observation group, with 43 patients in each group. The control group was given routine postoperative nursing, and the observation group was given targeted systematic nursing. The eyelid aesthetic effect, appearance satisfaction and complications were compared between the two groups. Results The scores of bilateral eyelid width symmetry, upper eyelid contour and bilateral eyelid height symmetry in the observation group were higher than those in the control group (P <0.05). The appearance satisfaction of the observation group was 97.67%, which was higher than 74.42% of the control group (P <0.05). The incidence of complications in the observation group was 4.65%, which was lower than 25.58% in the control group (P <0.05). Conclusion Targeted systematic nursing for patients undergoing ptosis surgery has a good effect, which can improve the aesthetic effect of postoperative eyelids, reduce the incidence of complications, and improve the appearance satisfaction of patients.