Objective To explore the effect of adjacent flap repair on scar condition and quality of life in patients undergoing excision of eyelid mass. Methods A total of 62 patients who underwent excision of eyelid mass in Yancheng City Dafeng People's Hospital from January 2023 to December 2024 were selected as the research subjects, and they were divided into the control group and the observation group according to the random number table method, with 31 patients in each group. The control group was treated with direct suture after excision of eyelid mass, and the observation group was treated with adjacent flap repair after excision of eyelid mass. The perioperative indexes, scar condition, complication rate and quality of life were compared between the two groups. Results The tear break-up time in the observation group was longer than that in the control group, and the tear meniscus height was higher than that in the control group (P <0.05). The scores of scar color, hardness, thickness and pain in the observation group were lower than those in the control group (P <0.05). The incidence of postoperative complications in the observation group was 3.23%, which was lower than 25.81% in the control group (P <0.05). The scores of all dimensions of quality of life in the observation group after treatment were higher than those in the control group (P <0.05). Conclusion The application of adjacent flap repair after excision of eyelid mass has a good effect. It can effectively prolong the tear break-up time, increase the tear meniscus height, improve scar repair condition, reduce the incidence of complications, and enhance patients' quality of life.