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Purpose: To evaluate the clinical manifestations of epiblepharon in Korean children and the relationship between this condition and body mass index. Methods: In a retrospective case-control study, 223 children 6 to 1.5 years of age treated surgically for epiblepharon were studied and compared with an age-matched control group of 264 children. Data on age, sex, weight, height, and recurrence were recorded. Results: Mean age of the patients was 8.63 ± 4.43 years. Lower eyelids were commonly involved bilaterally. Chief complaints included ocular discomfort, eye rubbing, visual disturbances, photophobia, and epiphora. Minimal resection of orbicularis oculi with full-thickness eyelid rotatory suture for epiblepharon was performed on 223 patients. The body mass index in girls 12 to 15 years old with epiblepharon was significantly higher than that in children without epiblepharon (P < .05). There was a statistically significant correlation between the incidence of epiblepharon and obesity with aging in girls (P < .05). Reoperation was performed on 12 patients (4.4%) because of recurrence of corneal irritation with inverted eyelashes. Clinical factors such as sex, age, and body mass index did not affect the rate of recurrence. Conclusion: Epiblepharon is one of the most common eyelid abnormalities among Asian children. Obese Korean girls aged 12 to 15 years demonstrated symptomatic epiblepharon at a statistically significant level. [ABSTRACT FROM AUTHOR]