Objective To observe the clinical effects of frontal muscular flap suspension surgery in the treatment of unilateral severe blepharoptosis. Methods Totally 23 patients with unilateral severe blepharoptosis received frontal muscular flap suspension surgery, including 9 males and 14 females, with 12 in the left side and 11 in the right side. Results Nineteen patients (82.61%) were corrected satisfactorily and 4 (17.39%) were corrected basically, with no failure cases. During a follow-up of 6 months, the eyelids restored to the normal positions in all the 23 cases, with good facial function, flexible movement, and appropriate, symmetrical palpebral fissure, and with no complications. Conclusion Frontal muscular flap suspension surgery is a safe, effective operation for unilateral severe blepharoptosis; it can correct the deformity, restore the eyelid function, improve the cosmetic appearance and has less complications.