Objective To explore the effect of minimally invasive double eyelid surgery on surgical indicators and pain degree in patients with asymmetric double eyelids. Methods A total of 167 patients with asymmetric double eyelids admitted to the Department of Dermatology, Air Force Medical Center from January 2021 to December 2023 were selected as the research subjects, and they were divided into the control group (n =73) and the observation group (n =94) according to different treatment methods. The control group was treated with traditional incisional double eyelid surgery, and the observation group was treated with minimally invasive double eyelid surgery. The clinical efficacy, surgical indicators, postoperative pain degree, satisfaction and adverse reactions were compared between the two groups. Results The effective rate of treatment in the observation group was 97.87%, which was higher than 84.93% in the control group (P <0.05). The intraoperative blood loss, operation time and incision healing time in the observation group were better than those in the control group (P <0.05). The NRS scores of the observation group at 1, 3 and 7 days after operation were lower than those in the control group (P <0.05). The treatment satisfaction of the observation group (95.74%) was higher than that of the control group (75.34%) (P <0.05). The incidence of adverse reactions in the observation group was 2.13%, which was lower than 17.81% in the control group (P <0.05). Conclusion Minimally invasive double eyelid surgery has an ideal effect in the repair of asymmetric double eyelids, with advantages such as fewer adverse reactions, faster recovery and less pain, which can effectively improve patient satisfaction.