Objective To explore the therapeutic effect of free tissue graft in the treatment of cicatricial entropion caused by thermal burns. Methods Sixty patients with cicatricial entropion caused by thermal burns admitted to our hospital from October 2022 to October 2023 were selected as the research objects. They were divided into experimental group 1 and experimental group 2 by random number table method, with 30 patients in each group. The experimental group 1 was treated with autologous tarsalconjunctival flap free transplantation, and the experimental group 2 was treated with allogeneic sclera tissue free transplantation. The clinical efficacy, complications and improvement of eye symptom scores in the two groups were compared. Results The total effective rate of treatment in the experimental group 1 was 100.00%, which was higher than 86.67% in the experimental group 2 (P <0.05). The incidence of complications in the experimental group 1 was 6.67%, which was lower than 20.00% in the experimental group 2 (P <0.05). The scores of ocular foreign body sensation, irritation and tears in the experimental group 1 were lower than those in the experimental group 2 (P <0.05). Conclusion The effect of autologous tarsal-conjunctival flap free transplantation in the treatment of cicatricial entropion caused by thermal burns is ideal. It has good stability and compatibility, and can effectively improve the eye symptoms of patients. Meanwhile, the incidence of postoperative complications is small, and the application safety is high.