Objective To explore the clinical effect of orbicularis oculi muscle shortening in the treatment of senile lower eyelid entropion combined with skin relaxation. Methods Sixty patients with senile lower eyelid entropion and skin relaxation who were treated in our hospital from December 2022 to December 2023 were selected as the research objects. They were divided into reference group and experimental group by random number table method, with 30 patients in each group. The reference group was treated with traditional orbicularis oculi muscle shortening, and the experimental group was treated with modified orbicularis oculi muscle shortening. The clinical efficacy, ocular symptom score and advers reactions were compared between the two groups. Results The total effective rate of treatment in the experimental group was 93.33%, which was higher than 76.67% in the reference group (P <0.05). Ater treatment, the scores of eye photophobia, tears, irritation and foreign body sensation in the experimental group were lower than those in the reference group (P <0.05). The incidence of complications in the experimental group was 3.33%, which was lower than 16.67% in the reference group (P <0.05). Conclusion Modified orbicularis oculi muscle shortening is more effective in the treatment of senile lower eyelid entropion complicated with skin relaxation, which can effectively improve the discomfort symptoms of patients after operation and reduce the incidence of postoperative complications. It is worthy of application.