Objective To analyze the efficacy and safety of combined fascial sheath+levator palpebrae superioris compound flap suspension in the treatment of children with ptosis. Methods A total of 80 children with ptosis admitted to our hospital from February 2022 to February 2024 were randomly divided into control group and study group, with 40 children in each group. The control group was given frontal muscle flap suspension, and the study group was given combined fascial sheath+levator palpebrae superioris compound flap suspension. The degree of upper eyelid regression, the range of upper eyelid movement, the recovery of ocular surface function indexes and the occurrence of complications were compared between the two groups. Results The area of upper eyelid retraction in the study group was smaller than that in the control group at 1 and 3 months after operation, and the range of upper eyelid movement was larger than that in the control group (P <0.05). The tear secretion, tear film rupture time and corneal fluorescein staining score of the study group were better than those of the control group (P <0.05). The incidence of complications in the study group was 2.50%, which was lower than 17.50% in the control group (P <0.05). Conclusion The combined fascia sheath+levator palpebrae superioris muscle composite flap suspension is effective in the treatment of children with ptosis, which can effectively improve the symptoms of ptosis, improve the range of upper eyelid activity, promote the effective recovery of ocular surface function, and strengthen the final treatment effect. Meanwhile, the incidence of postoperative complications is small and the safety of treatment is high.