Involutional entropion, a condition in which the lower eyelid margin is rotated inward, occurs often in elderly people. It can result in corneal and conjunctival irritation by the inverted eyelashes. The pathophysiology has been attributed to multiple factors, including attenuation of the tarsal plate with age, enophthalmus occurring with aging, decreased action of the inferior palpebral muscle, and the overridge of the preseptal orbicularis oculi. Many surgical options have been described for the treatment of involutional entropion. We present an innovative surgical procedure for correction of involutional entropion by a horizontal tangential wedge excision of the tarsal plate.