Objective To observe the clinical effectof combined fascial sheath suspension in the treatment of moderate and severe ptosis. Methods From December 2020 to August 2021, 50 patients (50 eyes) with moderate and severe ptosis in the Department of Plastic Surgery, Guangzhou Zixin Plastic Surgery Hospital were selected. According to the surgical methods, they were divided into fascia sheath suspension group and frontal muscle flapsuspension group, with 25 cases (25 eyes) in each group. The correction of blepharoptosis, upper eyelid retraction, range of motion, MRD1, PFH, clinical effacy, postoperative complications and treatment satisfaction were compared between the two groups. Results The correction rate of ptosis in the fascial sheath suspension group was higher than that in the frontal muscle flap suspension group, and the overcorrection rate, undercorrection rate and recurrence rate were lower than those in the frontal muscle flapsuspension group (P<0.05). At 1 week, 1 month and 3 months after operation, the upper eyelid retraction in the fascial sheath suspension group was less than that in the frontal muscle flapsuspension group, and the range of motion was greater than that in the frontal muscle flapsuspension group (P<0.05). The total effectiverate of fascial sheath suspension group was 88.00%, which was higher than 64.00% of frontal muscle flapsuspension group (P<0.05). The incidence of postoperative complications in the fascial sheath suspension group was 8.00%, which was lower than 32.00% in the frontal muscle flap suspensin group (P<0.05). The satisfaction of upper vision treatment in the fascia sheath suspension group was higher than that in the frontal muscle flapsuspension group, and the satisfaction of flatvision treatment was higher than that in the frontal muscle flapsuspension group (P<0.05). Conclusion The clinical effectof combined fascia sheath suspension in the treatment of moderate to severe ptosis is better than that of frontal muscle fap suspension, which can effectivelyimprove the correction rate of ptosis, reduce the overcorrection rate, undercorrection rate and recurrence rate, narrow the upper eyelid retraction, expand the scope of activity, reduce the incidence of postoperative complications and improve the treatment satisfaction.