Objective To explore the clinical value and aesthetic effect of epicanthoplasty combined with double eyelid plasty. Methods A total of 74 patients who received ocular cosmetic plastic surgery at Liyang Hospital of Chinese Medicine from January 2024 to January 2026 were selected, and they were divided into the control group and the observation group according to different surgical methods, with 37 patients in each group. The control group was given double eyelid plasty, and the observation group was given epicanthoplasty combined with double eyelid plasty. The ocular morphology, aesthetic effect (Global Aesthetic Improvement Scale, GAIS), scar status (Vancouver Scar Scale, VSS) and complication rate were compared between the two groups. Results At 6 months after surgery, the inner canthal distance in the observation group was smaller than that in the control group, and the length of palpebral fissure was larger than that in the control group (P <0.05). There was no significant difference in the height of palpebral fissure between the two groups (P >0.05). At 6 months after surgery, the GAIS score of the observation group was better than that of the control group (P <0.05). The VSS scores of the two groups at 6 months after surgery were lower than those at 1 month after surgery (P <0.05), but there was no significant difference in VSS scores between the two groups at 1 and 6 months after operation (P >0.05). There was no significant difference in the incidence of complications between the two groups (P >0.05). Conclusion For patients receiving ocular cosmetic plastic surgery, epicanthoplasty combined with double eyelid plasty can further improve ocular morphology. The scar improvement effect is comparable to that of simple double eyelid plasty, while the combined procedureachieves better overall aesthetic effect, without increasing the risk of complications, presenting definite clinical application value.