Objective To evaluate the application effect of skin orbicularis oculi muscle composite tissue flap in the repair of eyelid avulsion injury. Methods A total of 74 patients with plastic repair of eyelid avulsion injury admitted to Heze Mudan People's Hospital from January 2020 to January 2023 were randomly divided into routine group and study group, with 37 patients in each group. The routine group was treated with arbitrary flap transfer repair, and the study group was treated with skin orbicularis oculi muscle composite tissue flap repair. The postoperative complications, wound healing and aesthetics satisfaction were compared between the two groups. Results The incidence of complications in the study group was 5.41%, which was lower than 24.32% in the routine group, the difference was statistically significant (P <0.05). The proportion of grade A healing in the study group was higher than that in the routine group, and the proportion of grade B and grade C healing was lower than that in the routine group, the differences were statistically significant (P <0.05). The aesthetics satisfaction of the study group was 97.30%, which was higher than 75.68% of the routine group, and the difference was statistically significant (P <0.05). Conclusion In the plastic repair treatment of eyelid avulsion injury, the skin orbicularis oculi muscle composite tissue flap repair surgery for patients can achieve better curative effect. It can not only effectively avoid related postoperative complications, but also ensure the surgical efficacy of patients and the requirements for facial aesthetics.