Reconstruction of the upper eyelid is one of the greatest challenges facing the orbitofacial surgeon. This comprehensive review outlines the principles of reconstruction and the range of techniques available. Methods of assessing upper eyelid defects are discussed, and an algorithm for reconstruction based on defect size and lamellar involvement is given. The review contains numerous detailed examples of reconstructive techniques, including secondary intention healing, local flaps, distal flaps, simple and composite grafts, occlusive and non-occlusive methods, and canthal fixation. Eyebrow and eyelash reconstruction is also covered.