Objective To analyze the clinical effects of double tile orbicularis oculi muscle flap method for pouch resection. Methods A total of 84 patients who underwent pouch resection in our hospital from May 2021 to May 2022 were selected as the research objects. According to the random number table method, they were divided into control group and study group, with 42 cases in each group. The control group was treated with traditional lower eyelid skin approach, and the study group was treated with double tile orbicularis oculi muscle flap method. The clinical efficacy, aesthetic score and incidence of adverse reactions were compared between the two groups. Results The total effective rate of treatment in the study group was 97.62%, which was higher than 83.33% in the control group (P<0.05). After treatment, the aesthetic score of the study group was higher than that of the control group (P<0.05). The incidence of adverse reactions in the study group was 2.38%, which was lower than 16.67% in the control group (P<0.05). Conclusion The double tile orbicularis oculi muscle flap method is effective in pouch resection, with high postoperative aesthetics, and will not increase the incidence of adverse reactions, which is worthy of clinical application.