Background and Objectives: Carbon dioxide (CO 2 ) laser and radiosurgery are techniques commonly employed in oculoplastic surgery. However, there is no literature comparing their results in blepharoplasty. Study Design/Materials and Methods: Twenty Chinese patients with dermatochalasis underwent radiosurgery in one upper eyelid and CO 2 laser in the contralateral eyelid. Intraoperative time, hemorrhage, and pain control were assessed. Subjects were evaluated at postoperative 1 hour, 1 week, 1 month, and 3 months for hemorrhage and wound healing by a masked assessor. Results: All patients reported minimal pain with either technique. A significantly shorter operative time was achieved with CO 2 laser, with better intraoperative hemostasis. There was no significant difference in postoperative hemorrhage and wound swelling between radiosurgery and CO 2 laser. No significant intraoperative complications were noted. Conclusions: Both radiosurgery and CO 2 laser are equally safe and effective for upper lid blepharoplasty. CO 2 laser achieves shorter operative time with superior intraoperative hemostasis.