To evaluate the clinical effect of surgical resection combined with lipid-lowering in the treatment of xanthelasma palpebrarum. Methods From January 2020 to January 2022, 50 patients (100 eyes) diagnosed with xanthelasma palpebrarum combined with hyperlipidemia in the Department of Ophthalmology, Leshan People's Hospital were selected for retrospective study. They were divided into experimental group and control group according to different treatment methods, with 25 patients (50 eyes) in each group. The experimental group was treated with surgical resection combined with lipid-lowering therapy, and the control group was only treated with surgical resection. The clinical efficacy, recurrence and complications were compared between the two groups. Results After 1 year of follow-up, the total effective rate of the experimental group was 92.00%, which was compared with 88.00% of the control group, the difference was not statistically significant (P >0.05). The recurrence rate of the experimental group was 8.00%, which was lower than 32.00% of the control group (P <0.05). There were no surgical complications such as eyelid deformity, wound nonunion, eyelid closure insufficiency, eyelid ectropion and ectropion in the two groups. Conclusion Surgical resection combined with lipid-lowering therapy has a definite clinical effect in the treatment of xanthelasma palpebrarum patients with elevated blood lipids, which can effectively improve the therapeutic effect, reduce the recurrence rate, and will not produce complications.