Congenital ptosis is a common ophthalmologic condition in children with either monocular or binocular onset, and is mainly caused by hypoplasia of the nucleus accumbens or hypoplasia of the levator muscle. The early onset of ptosis affects the child’s appearance and psychological development in the milder cases, while in the more severe cases it affects visual acuity and leads to form-deprivation amblyopia, which affects the development of binocular vision. Early surgical correction of ptosis is an effective way to gain vision and prevent amblyopia. Abandoning surgery in childhood can result in lifelong visual impairment in children with ptosis. Ptosis can be classified by degree as mild, moderate, or intermediate ptosis. The goal of ptosis surgery is to correct the upper eyelid and restore upper eyelid function and visual function, and most surgery is performed under general anesthesia, so timing and quantification are key to successful surgery. There are three types of ptosis surgery: one that utilizes the strength of the frontalis muscle, two that utilizes the strength of the levator muscle, and three that utilizes the upper rectus muscle lift. The third type is often followed by diplopia and downward strabismus is no longer used. The levator aponeurosis is the main muscle that lifts the upper eyelid and is the main cause of ptosis, so using the power of the levator aponeurosis to treat ptosis is a more ideal and physiologically consistent procedure, both anatomically and physiologically. However, this procedure is only suitable for patients with an upper eyelid muscle strength of 5 mm or more, and is not effective in patients with severe ptosis who have a severe deficit in upper eyelid muscle strength. The frontalis flap suspension for severe ptosis in children has the following advantages over the traditional frontalis flap suspension: (1) The postoperative incomplete lid fissure closure and delayed upper lid movement are improved compared to the traditional procedure because they are more anatomically correct, and the long-term results are more stable and less likely to recur. (2) The frontalis perineural nerve is rich in blood flow, which reduces the damage to the surrounding tissues, and the frontalis flap has good blood flow and better healing effect. (3) Since the frontalis fascia flap passes through the lid plate via the tunnel under the orbicularis oculi, its action is close to that of the levator muscle, making postoperative eyelid movement more natural. In children who are too young, the immaturity of both the levator and frontalis muscles may affect the outcome of the surgery, so hospitals choose to operate on patients over 2 years of age. However, in cases of moderate ptosis that affects binocular vision and other factors that contribute to amblyopia (e.g., moderate to severe refractive error, refractive error, etc.), the timing of surgery will be determined based on the child’s condition.