Objective To explore the clinical efficacy of small incision degreasing combined with continuous embedding double eyelid surgery in the correction of asymmetric double eyelids. Methods A total of 80 patients with asymmetric double eyelids admitted to the Plastic and Aesthetic Center, the 72nd Group Army Hospital from January to December 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group was treated with conventional full incision double eyelid surgery, and the observation group was treated with small incision degreasing combined with continuous embedding double eyelid surgery. The clinical efficacy, ocular aesthetic scores and complication rate were compared between the two groups. Results The total effective rate of the observation group was 95.00%, which was higher than 82.50% of the control group (P <0.05). After operation, the single-item scores of double eyelid symmetry, double eyelid smoothness, eyelid naturalness, incision scar aesthetics and total aesthetic score in the observation group were higher than those in the control group (P <0.05). The incidence of complications in the observation group was 2.50%, which was lower than 12.50% in the control group (P <0.05). Conclusion Small incision degreasing combined with continuous embedding double eyelid surgery is minimally invasive, safe and capable of achieving symmetric and natural shaping, with favorable aesthetic effect. It can precisely correct asymmetric double eyelid deformity accompanied by mild to moderate orbital septal fat accumulation and good eyelid skin elasticity, satisfying clinical correction demands for such patients, and possesses high clinical application value.