Clinical efficacy of conjoint fascial sheath suspension and frontalis muscle suspension was explored in treating moderate or severe congenital ptosis and their effects on ocular surface and refractive status. A total of 75 patients with moderate or severe ptosis (108 eyes) treated in Yidu Central hospital from June 2014 to June 2019 were enrolled in this study, and divided into group A and group B. Group A was treated with conjoint fascial sheath suspension (n=38, 55 eyes), while group B was treated with frontalis muscle suspension (n=37, 53 eyes). The following data of the two groups were compared: General baseline data, total correction efficiency, satisfaction, and ocular surface after surgery, refractive status, and complications at three months after surgery. The two groups showed no significant difference in general data (P>0.05), but group A showed higher total correction efficiency and satisfaction, and less complications than those in group B (all P<0.05). In addition, the two groups had no difference in terms of ocular surface, tear break-up time, or Schirmer test level after surgery (all P>0.05), and showed no refraction changes after surgery (P>0.05). In terms of refractive status and ocular surface, the two surgery methods are not very different, but in terms of efficacy, conjoint fascial sheath suspension is more advantageous than frontalis muscle suspension, and it brings less complications, and enjoys a higher satisfaction, so it is worthy of promotion.