Objective To investigate the efficacy and safety of transconjunctival orbital septum fat release for correction of lacrimal groove depression. Methods A total of 92 patients with lacrimal groove depression admitted to Xi'an Yimei’er Medical Cosmetology Hospital from April 2019 to May 2021 were selected as the research objects. According to the random number table method, they were divided into control group and study group, with 46 patients in each group. The control group was treated with lower eyelid blepharoplasty through conjunctival approach, and the study group was treated with orbital septum fat release correction through conjunctival approach. The clinical efficacy, satisfaction, severity of tear trough depression and complications were compared between the two groups. Results The total effective rate of treatment in the study group was 97.83%, which was higher than 86.96% in the control group (P <0.05). The satisfaction rate of the study group was 100.00%, which was higher than 86.96% of the control group (P <0.05). The TTRS score of the two groups at 6 months after operation was lower than that at 1 day before operation, and that of the study group was lower than that of the control group (P <0.05). The incidence of complications in the study group was 4.35%, which was lower than 19.57% in the control group (P <0.05). Conclusion Transconjunctival orbital septum fat release is effective in correcting lacrimal groove depression. It has the advantages of minimally invasive, safe and effective, and has high patient satisfaction, which is worthy of application.