It has recently been noted that some patients who complain of blepharoptosis actually have blepharospasm. However, to the best of my knowledge, no study has yet examined the involvement of blepharospasm in blepharoptosis. The author retrospectively reviewed patients who expressed dissatisfaction with blepharoptosis surgery on a patient-satisfaction survey, and examined the involvement of blepharospasm in these patients. Two out of 10 patients who were dissatisfied with blepharoptosis surgery showed photophobia and increased contraction of the facial muscles, and seemed to have had blepharospasm before surgery. The author also prospectively examined patients who visited his clinic for blepharoptosis, and tested whether the patients had blepharospasm. Among the 75 patients who requested blepharoptosis treatment, 11 were diagnosed with mild blepharospasm, and 2 with severe blepharospasm. The two severe cases were treated with botulinum toxin, rather than with surgery. Some patients who have blepharospasm believe that they have blepharoptosis, and request blepharoptosis treatment at clinics. We should be aware of the potential involvement of blepharospasm in our clinical experience of patients with blepharoptosis.