We reviewed retrospectively 170 cases of congenital and acquired oculomotor nerve palsy to determine the effectiveness of surgery in the treatment of blepharoptosis in oculomotor nerve palsy. Twenty patients had had surgical repair of the blepharoptosis. Patients with congenital oculomotor palsy were more often selected for blepharoptosis surgery than patients with acquired blepharoptosis because of the absence of diplopia caused by suppression in congenital cases. There was complete recovery in 72 of 109 patients (66%) with acquired oculomotor palsy. Results were judged with regard to functional improvements and cosmetic improvement. Primary functional disability was relieved by lifting the eyelid above the pupil in ten of 12 patients (83%). Primary cosmetic disability was relieved in six of six patients. Corneal complications occurred in six of 20 patients (30%) who were treated surgically.