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The goals of eyelid reconstruction are 3-fold: (1) to provide adequate eyelid function, (2) to afford globe protection, and (3) to achieve acceptable aesthetic results. The most common indication for upper eyelid reconstruction is defects due to resection of malignancies. Imaging studies such as CT scan or MRI may be necessary to plan surgical excision of a tumor. They also may aid in predicting the extent of the defect and the availability of adjacent tissues for reconstruction. The skin of the opposite eyelid skin and preauricular area represent readily available sources for skin grafts. The surgical outcome for eyelid reconstruction is mostly dependent on the extent of the primary defect. Larger defects necessitate more complicated reconstruction with associated risks of complications. In general, reconstruction in older patients is easier because of the increased tissue redundancy and more laxity. The primary goal of upper eyelid reconstruction should be globe protection. Aesthetic results constitute a secondary goal.