Objective To analyze the clinical efficacy of small incision fusion degreasing combined with catgut embedding in the treatment of asymmetric double eyelid. Methods From January 2020 to December 2022, 132 patients with asymmetric binoculus who underwent surgical treatment in Shanxian Central Hospital were selected and divided into conventional group and experimental group according to random number table method, with 66 cases in each group. The conventional group was treated with conventional incision, and the experimental group was treated with small incision fusion degreasing combined with catgut embedding. The surgical indexes, clinical efficacy, complications, pain degree (VAS score) and patient satisfaction were compared between the two groups. Results The operation time, intraoperative blood loss, incision healing time and hospitalization time in the experimental group were lower than those in the conventional group (P<0.05). The VAS scores of the experimental group at 1,2 and 6 h after operation were lower than those of the conventional group (P<0.05). The total effective rate of treatment in the experimental group was 98.48%, which was higher than 89.39% in the conventional group (P<0.05). The incidence of complications in the experimental group was 3.03%, which was lower than 12.12% in the conventional group (P<0.05). The satisfaction in the experimental group was 98.48%, which was higher than 87.88% in the conventional group (P<0.05). Conclusion Small incision fusion degreasing combined with catgut embedding is effective in the treatment of asymmetric doubleeyelids. It has the advantages of small trauma, low postoperative pain and fast recovery. Meanwhile, the incidence of postoperative complications is low and patient satisfaction is high