Objective To explore the effect of targeted systematic nursing on postoperative psychological state and appearance satisfaction of patients with ptosis surgery. Methods A total of 73 patients with ptosis admitted to our hospital from January 1, 2018 to November 16, 2023 were selected as the research objects. According to the time of admission, they were divided into control group (January 1, 2018-December 31, 2020, n =32) and observation group (January 1, 2021-November 16, 2023, n =41). The control group was given routine postoperative nursing, and the observation group was given targeted systematic nursing. The eyelid aesthetic effect, psychological state and appearance satisfaction of the two groups were compared. Results The scores of upper eyelid contour, symmetry of double eyelid width and symmetry of double eyelid height in the observation group were higher than those in the control group, and the differences were statistically significant (P <0.05). After nursing, the scores of GAD- 7 and PHQ-9 in the observation group were lower than those in the control group, the differences were statistically significant (P <0.05). The appearance satisfaction of the observation group was 97.56%, which was higher than 78.13% of the control group, and the difference was statistically significant (P <0.05). Conclusion Targeted systematic nursing after ptosis surgery can improve the aesthetic effect of eyelids, reduce their negati ve emotions, and improve their appearance satisfaction.