Combined procedures that address multiple etiologic factors in involutional entropion are not new, but ophthalmic surgeons have been slow to accept this surgical approach. Traditional procedures that correct only one or two of the etiologic factors have a high incidence of recurrent entropion. The purpose of this article is to encourage the use of a combined procedure in the treatment of all cases of primary and recurrent entropion to minimize recurrences. Between 1983 and 1989, 127 consecutive eyelids with involutional entropion in 97 patients were operated by the senior author (R.P.C.) using the procedure described in this paper. Of these eyelids, 39% (49) had previous surgery and 22% (28) had more than one previous procedure. Although occasional minor postoperative problems occurred, they were readily managed, and there have been no known recurrences of entropion with an average follow-up of 33 months.