Autologous fat filling is a research hotspot in plastic and aesthetic surgery in recent years. It is gradually widely used in clinical practice because of its advantages of simple operation, small trauma and rich source of transplantation. However, there are still some shortcomings in this technique, such as uncertain survival rate and local mass, which can lead to fat embolism, hemiplegia and even death in severe cases. Upper eyelid fat granuloma after facial autologous fat filling is one of its complications. The specific cause is not clear, which may be caused by inactive autologous fat. The location of the tumor is directly related to the site of fat filling. The clinical manifestations of patients can be sudden unexplained swelling of the upper eyelid, mild pain, foreign body sensation or ptosis, and difficulty in opening eyes. However, the diagnosis is more complicated, and it is easy to be misdiagnosed or overtreated, which affects the prognosis of patients. This study retrospectively analyzed the clinical data of 90 patients with upper eyelid fat granuloma after facial autologous fat filling in our hospital from March 2020 to September 2022, observed the characteristics and imaging features of upper eyelid fat granuloma, and analyzed its clinical treatment methods, in order to provide some reference for its clinical diagnosis and treatment of the disease.