Congenital ptosis is a partial or complete drooping of the upper eyelid that obscures the cornea (black eye) by more than 2 mm due to weakness or disability of the levator muscle, which is responsible for opening the eye, or congenital hypoplasia of the innate nerve and nucleus. Ptosis not only affects appearance, but in developing children, it can affect vision development leading to amblyopia and can also have a negative impact on the child’s psychological and personality development, so it should be treated promptly to prevent complications so that the child can grow up healthy. However, because children’s organs are not yet mature, ptosis correction surgery is not as early as it should be, and a variety of factors need to be taken into account to determine the timing of surgery. First, the ideal outcome for ptosis correction surgery is symmetrical eyes and natural-looking lids, which requires that the patient’s relevant organs and tissues are mature and that they are able to cooperate well with the surgeon during preoperative and intraoperative examinations. In infants and young children, the organs are not yet mature enough to cooperate with the relevant examinations, which greatly limits the choice of surgical approach. Moreover, the surgery must be performed under general anesthesia, and the volume of surgery is not easy to control. Therefore, from an aesthetic standpoint, ptosis correction surgery should be performed best in adulthood, when local anesthesia can be tolerated. Second, from the perspective of affecting vision development. Severe ptosis in one eye and severe ptosis in both eyes can affect the normal vision of the affected eye, as visual development is mainly completed before the age of 5, and the younger the person, the more rapid the visual development. If the pupil is obscured by ptosis early in life, light cannot enter the eye to produce visual stimulation and the retina does not develop normally, which can lead to amblyopia within weeks to months and is very difficult to treat once it occurs. Therefore, these children should be treated with surgery or other effective methods to open the eyelids to allow light to enter the eye and prevent amblyopia from occurring. In children with mild and moderate ptosis in one eye, as long as the lid does not cover the pupil, vision development will not be affected; in most children with ptosis in both eyes, most will avoid the pupil blockage by looking up. In these children, surgery can be postponed, but in the meantime, regular vision exams should be performed at specialized hospitals, and any abnormalities should be treated as soon as possible under medical supervision. Finally, from the perspective of affecting psychological and personality development. Ptosis can easily lead to strange looks and even discrimination, which can cause children to avoid contact and communication with others and develop a withdrawn, low self-esteem personality. In the early years of life, when the child is not clearly self-aware, the effects are less pronounced. At this time, the family should learn to accept the child’s physical abnormalities openly and try not to mention it in front of the child, so that the child ignores the existence of physical abnormalities and grows up healthy with a positive attitude. At the age of 3 to 5 years old, the child’s self-awareness begins to increase, mental development gradually accelerates, and the scope of exposure becomes more and more extensive. At this time, the development of the eye is basically close to the adult level, and surgical correction can be considered to facilitate the child’s better integration into society. Of course, the specific surgery time should also consider the child’s own personality, cheerful children with less psychological impact can be delayed, and introverted and sensitive children can be appropriately advanced. In addition, for patients with strabismus, the strabismus should be corrected before the ptosis is corrected; for patients with narrow lid syndrome, it is best to perform the surgery in stages, starting with internal and external canthoplasty and then correcting the ptosis six months later; for patients with Marcus-Gunn syndrome (mandibular transient syndrome), most of the symptoms can gradually decrease or disappear with age, but usually the ptosis is not considered until after puberty. In most cases, surgery is not considered until after puberty. In conclusion, the timing of surgery for ptosis in children should be based on a number of factors, and the child’s visual development should be closely monitored while waiting for surgery to avoid complications such as amblyopia.