Background <p>This study focuses on blepharoptosis, a common condition in oculoplastic surgery characterized by drooping of the upper eyelid. The efficacy and safety of using the combined fascial sheath (CFS) to correct blepharoptosis are still unclear.</p> Methods <p>A systematic search encompassing four databases (PubMed, Embase, Web of Science, and Cochrane Library) up to December 15, 2023, was conducted. The meta-analysis was performed using Stata 14.</p> Results <p>A total of 10 studies involving 683 patients were included. The meta-analysis indicated a significant improvement in mean marginal reflex distance 1 (MRD1) in the CFS group compared to the control group (WMD: 2.33; 95% CI 1.61 to 3.06; <i>I</i>²=97.2%, <i>P</i> &lt; 0.001). Additionally, patient satisfaction in the CFS group was significantly higher than in the control group (OR: 5.28; 95% CI 1.71 to 16.32; <i>I</i>²=0, <i>P</i> = 0.683), and the complication rate was significantly lower (OR 0.26; 95% CI 0.14 to 0.48; <i>I</i>²=0, <i>P</i> = 0.899). However, no significant difference in curative effect was observed between the two groups (RD: 0.15; 95% CI −0.01 to 0.31; <i>I</i>²=88.3%, <i>P</i> &lt; 0.001).</p> Conclusion <p>CFS suspension has the potential to significantly improve MRD1 and patient satisfaction, while exhibiting a low incidence of complications and a favorable safety profile. These findings indicate that clinicians might consider CFS suspension as a viable treatment option for blepharoptosis. However, it is important to exercise caution due to inter-study heterogeneity and the limitations of current analysis.</p> Level of Evidence III <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a></p>