This was a retrospective study looking at effectiveness of skin-muscle flap in conjunction with a lateral tarsal strip for the correction of involutional entropion. Lateral tarsal strip was combined with a subciliary incision from canthotomy to just lateral to lacrimal punctum. Skin-muscle flap was dissected inferiorly and the redundant tissue was excised. Follow-up information was determined from patient charts and telephone interviews to screen for recurrent entropion. Eighty-three consecutive patient charts were reviewed, of which 80 patients (93 eyelids) were included. No intraoperative complications were noted. Average follow-up period was 502 days and only one patient developed recurrence which settled with Quickert sutures. Two patients had mild overcorrection which did not need surgery. The authors conclude that this technique which addresses horizontal and vertical lid laxity, gives excellent functional and cosmetic outcomes. They also discuss effectiveness of various other techniques. The limitations of this study are the short follow-up period and use of telephone interviews to determine recurrence.