The classical approach to rehabilitative surgery for thyroid eye disease is a staged approach starting with orbital surgery, followed by squint surgery, correction of eyelid retraction and finally blepharoplasty resulting in three or four surgeries [1]. Whilst not all patients will require all these surgeries, they are usually considered in this order. This approach has long been preferred because each surgery can have ramifications that affect subsequent surgeries and cannot easily be predicted and addressed during simultaneous surgeries. There have been many papers expressing support for the staged surgical approach to restorative surgery for thyroid eye disease [2]. However these largely present expert consensus, and a small but growing amount of literature exists that presents a counter argument against this recognised sequence in specific circumstances. This chapter explores the rationale and evidence behind the commonly advocated sequential approach and examines the appropriate timing for each of the steps.