This study was undertaken to evaluate the clinical characteristics and efficacy of the lateral tarsal strip (TS) and medial spindle procedure (MS). We conducted a retrospective chart review of the patients who underwent TS and MS between September 2008 and July 2011 by a single surgeon (S.H.B.). Data were collected on patient age, sex, laterality, diagnosis, procedures performed simultaneously, follow-up duration, postoperative complications, and surgical outcomes. One hundred eleven eyelids of 74 patients who underwent TS and 41 eyelids of 29 patients who underwent MS were included in this study. Patients' mean age was 61.5 years (range, 24-82) in the TS group and 68.2 years (range, 45-89) in the MS group. The most common diagnoses were lower lid laxity (54.1%) and involutional entropion (26.1%) in the TS group, and punctal ectropion in the MS group (95.1%). The percentage of patients who underwent an additional simultaneous procedure was 86.5% of the TS group and 92.7% of the MS group. Endoscopic dacryocystorhinostomy was the most commonly performed simultaneous procedure in both TS and MS groups (28.1% and 65.8%, respectively). Success rates were 96.4% in the TS group and 97.6% in the MS group. In the TS group, 3 eyelids (2.7%) required reoperation. The most common complication was chemosis in both TS and MS groups (51.4% and 50%, respectively). TS and MS are commonly performed simultaneously with other surgical procedures. These procedures aim to resolve lower lid laxity and punctal ectropion as well as relieve the symptoms of epiphora by stabilizing medial and lateral lid laxity. This review of the clinical features and effectiveness of MS and TS procedures provides useful information for clinicians.