Objective To analyze the effect of targeted systematic nursing on eyelid aesthetic effect in patients undergoing ptosis surgery. Methods A total of 60 patients who underwent ptosis surgery in our hospital from July 2023 to July 2025 were selected as the research subjects. According to the random number table method, they were divided into the reference group and the observation group, with 30 patients in each group. The reference group received conventional nursing, and the observation group received targeted systematic nursing. The eyelid aesthetic effect, appearance satisfaction, complication rate and nursing compliance were compared between the two groups. Results The scores of eyelid symmetry, eyelid height and eyelid margin morphology in the observation group were better than those in the reference group (P<0.05). The appearance satisfaction and nursing compliance of the observation group were higher than those of the reference group (P<0.05). The incidence of complications in the observation group (3.33%) was lower than that in the reference group (20.00%) (P<0.05). Conclusion Targeted systematic nursing for patients undergoing ptosis surgery can effectively improve eyelid aesthetic effect, nursing satisfaction and nursing compliance, and reduce the incidence of complications.