Abstract Background Direct damage to the superior rectus (SR) muscle insertion following upper lid blepharoplasty has not been reported. We document a rare case of vertical diplopia due to direct damage to the SR muscle insertion following cosmetic upper lid blepharoplasty. Case presentation We describe a case of 24-year-old woman with Asian eyelid. https://www.mariameetsanna.com/product-category/8-3-8g/