Lower lid malposition is a common yet demanding problem that both functional and cosmetic eyelid surgeons will face. It encompasses a spectrum of lower eyelid conditions ranging from lower lid retraction to frank ectropion and entropion. The causes of lower lid malposition are numerous, and the problem can be challenging to correct even for experienced surgeons. Proper treatment of lower lid malpositioning requires a clear understanding of the lower eyelid anatomy, careful preoperative assessment, and appropriate selection of surgical and nonsurgical interventions to have a successful outcome.