Objective To investigate the clinical effect of percutaneous pouch excision in blepharoplasty. Methods A total of 46 patients with pouch plastic surgery admitted to our hospital from October 2021 to October 2022 were selected as the research objects. They were divided into control group and observation group by random number table method, with 23 patients in each group. The control group was treated with traditional myocutaneous flap blepharoplasty, and the observation group was treated with percutaneous pouch resection. The clinical efficacy, postoperative recovery time, satisfaction and complications were compared between the two groups. Results The total effective rate of treatment in the observation group was 95.65%, which was higher than 69.57% in the control group (P<0.05). The postoperative recovery time of the observation group was shorter than that of the control group (P<0.05). The satisfaction score of the observation group on the day after operation and at 1, 6 and 12 months after operation were higher than those of the control group (P <0.05). The incidence of complications in the observation group was 13.04%, which was lower than 43.48% in the control group (P<0.05). Conclusion The application of percutaneous pouch excision in pouch plastic surgery is effective. It can not only improve the treatment effect, shorten the postoperative recovery time of patients, but also effectively reduce the incidence of complications, which is conducive to improving the satisfaction of patients. It is worthy of clinical application.