Lower lid entropion or inversion is a common involutional inward rotation of the tarsus and eyelid margin. It is caused by a combination of horizontal laxity of the eyelid, attenuation or disinsertion of eyelid retractors, and overriding of preseptal over pretarsal orbicularis muscle fibers. These changes result in the instability of the eyelid with age. The inverted eyelid leads to constant rubbing of eyelashes against the cornea and the globe, causing irritation, foreign body sensation, and in severe cases, corneal erosion, pannus formation, and ulceration. The lateral tarsal strip procedure is aimed at addressing the causes of entropion, thus correcting the eyelid position and improving its function. Upon successful surgical intervention, normal eyelid position and function are restored. Cosmesis of the eyelid also improves. This article will discuss the preoperative assessment of the patient, the preparation, the surgical procedure, and possible complications.