The need for surgery for chalazia depends on the site of occurrence, size, whether it affects eyelid function, appearance, and the patient’s wishes. In general, if the chalazion is small, the mass is not obviously elevated, the redness and swelling and pressure pain are not prominent, and it is only touched when the eyelid is unintentionally touched, this type of chalazion does not affect the appearance or eyelid function and does not require surgery. If the chalazion is large and affects appearance and function, it can be temporarily observed or observed with local heat, and if it is gradually absorbed and becomes smaller or even completely absorbed, surgery is not required. If the chalazion is large and even affects the vision of the eyes, surgery should be performed to scrape the contents or eliminate the granuloma to close the incision smoothly, but this case is very rare. If the chalazion continues to grow and the patient is older, surgical excision and pathological examination are recommended to exclude malignant tumors. In summary, in the vast majority of cases, chalazia without surgery does not affect the function of the eyelid and therefore does not cause serious problems other than cosmetic ones. However, chalazia that continues to increase in size and in older patients should be aggressively removed surgically and examined pathologically.