Background: Entropion is the inward turning of the lid margin that brings both lashes and external keratinized skin into contact with the globe. Aim of the study: It was to compare the surgical outcome and aesthetic appearance between anterior lamellar repositioning only and anterior lamellar repositioning with blepharoplasty in management of upper eye lid entropion trichiasis. Patients and Methods: This was prospective interventional study includes 20 lids of 13 patients with upper eyelid cicatricial entropion selected from the ophthalmology outpatient clinic of "Ain Shams University" Hospitals. Patients were randomly divided in 2 groups: group A: Ten lids had an anterior lamellar reposition technique (ALR) with grey line split (GLS) technique. Group B: Ten lids had an anterior lamellar reposition with GLS technique and blepharoplasty. All surgeries were performed by one surgeon (third author) in Ain Shams University hospital. Results: Our study showed that after 3 month follow up, success rate of first group was 70 %, patient satisfaction was 60% and final aesthetic outcome was 30% excellent, 30% fair and 40% poor results. The second group success rate was 100%, patient satisfaction was 100% and final aesthetic outcome was 100% excellent results. Conclusion: Combining the procedure of ALR with GLS technique with blepharoplasty in surgical correction of upper eye lid cicatricial entropion has excellent both functional and aesthetic outcome and a higher success rate with minimal complication than anterior lamellar reposition only.