Objective To explore the clinical efficacy of upper eyelid single-pedicle and double-pedicle myocutaneous flap transplantation in the repair of cicatricial ectropion. Methods A total of 80 patients with cicatricial ectropion admitted to the Department of Plastic Surgery, Xi'an Lianhu Huaji Hospital from January to July 2024 were selected, and they were divided into the control group (40 patients) and the study group (40 patients) according to different repair methods. The control group was given upper eyelid single-pedicle myocutaneous flap repair, and the study group was given upper eyelid double-pedicle myocutaneous flap repair. The clinical efficacy, myocutaneous flap indexes, complication rate and patient satisfaction were compared between the two groups. Results At 6 months after operation, the total effective rate of treatme nt in the study group (97.50%) was higher than that in the control group (80.00%) (P <0.05). The length of the myocutaneous flap in the study group was longer than that in the control group, and the w idth of the myocutaneous flap was wider than that in the control group (P <0.05). The incidence of complications in the study group was lower than that in the control group, and patient satisfaction was higher than that in the control group (P <0.05). Conclusion The upper eyelid double-pedicle myocutaneous flap is superior to the single-pedicle myocutaneous flap in terms of clinical efficacy, flap adaptability, safety and patient experience in the repair of cicatricial ectropion, with high clinical application value.