Eyelid surgery plays an important role in the management of a variety of ophthalmic diseases. Surgery on the adnexa and eye is routinely performed on an anesthetized patient. Minor procedures, such as conjunctival biopsy, may be performed in an awake patient using only topical anesthesia. Retrobulbar, peribulbar, and local anesthesia are less commonly used in general practice; however, they can provide significant advantages when used appropriately. Advantages to local anesthesia/sedation include being able to perform some ophthalmic procedures without having to place the patient under general anesthesia, ability to maintain the patient under a lighter plane of general anesthesia, improved postoperative comfort, and potentially smoother recoveries from general anesthesia. This article reviews this author's current indications and techniques for regional anesthesia as an adjunct to eyelid surgery in dogs.