Objective To estimate the safety and effectiveness of complete resection of the periorbital muscle for treating essential blepharospasm. Methods This study was a retrospective analysis. Forty-three patients diagnosed with essential blepharospasm were treated by completely resecting the periorbital muscles under local anesthesia. The effectiveness of the method was based on the grading norm of clinical blepharospasm， using the preoperative and postoperative contrasts， and conducting a follow-up survey during the 12 months postoperatively to identify eyelid dysraphisms or other complications. Results Among the 43 patients， preoperative blepharospasms were grade 3 and postoperative blepharospasms were grade 0 in 12 patients； the other 31 patients were grade 4 before surgery and after surgery were grade 0 in 4 patients， grade 1 in 25 paitients， and grade 2 in 4 patients. No eyelid dysraphism was found in the follow-up survey. Conclusion For clinical grading levels 3-4 in patients with idiopathic blepharospasm， comprehensive orbital muscle resection is useful and effective. The effectiveness of the procedure depends on the severity of the illness： the more severe preoperative， the less ideal effect.