Puffy eyes can be caused by a variety of reasons such as old age, poor lifestyle habits, and improper localized rubbing. Under-eye bags are bloated tissues of the lower eyelid in the shape of a hanging pouch. Patients with congenital under-eye bags are divided into two categories, congenital and acquired. Patients with congenital under-eye bags are born with a lack of elasticity and toughness of the connective tissue around the eyes and an accumulation of orbital fat. Patients with acquired eye bags are usually formed because of older age and gradual relaxation and atrophy of the lower eyelid skin; some patients have the problem of tear overflow and inappropriate rubbing of the lower lid during the process of constantly wiping tears, which causes the lower lid skin to relax and edema of the lower lid connective tissue to form eye bags; and some patients form eye bags because of long-term fatigue with eyes and staying up late. Eye bags do not cause substantial damage to the eyes, but are only treated for aesthetic reasons. Congenital under-eye bags are poorly treated by physical methods and conservative medication, only surgery can solve the problem, and the general effect of surgery is good. Acquired under-eye bags can be treated by paying attention to rest, local physical therapy and Chinese medicine to strengthen the spleen and benefit the qi, most of them can be cured or relieved, if the conservative treatment is not effective, it can also be solved by surgery. In conclusion, the causes of under-eye bags formation are related to various factors such as age and life habits, which can be improved by comprehensive treatment such as improving life habits, physiotherapy and TCM treatment, and if necessary, surgery.