To explore the clinical effect of minimally invasive double eyelid surgery in the plastic repair of asymmetric double eyelid patients. Methods A total of 100 patients with asymmetric double eyelids admitted to our hospital from January 2021 to January 2022 were randomly divided into conventional group and study group, with 50 patients in each group. The conventional group was treated with conventional plastic repair surgery, and the study group was treated with minimally invasive double eyelid surgery. The clinical efficacy, surgical related indicators and satisfaction were compared between the two groups. Results The effective rate of treatment in the study group was 96.00%, which was higher than 90.00% in the conventional group (P <0.05). The healing time and bleeding times of the study group were better than those of the conventional group (P <0.05). The satisfaction score of the study group was higher than that of the conventional group (P <0.05). Conclusion Minimally invasive double eyelid surgery is effective in asymmetric double eyelid repair, which can promote incision healing, reduce bleeding, and improve patient satisfaction.