Lower lid retraction is commonly seen in dysthyroid orbitopathy. We have treated 55 lower lids in 38 patients with lower lid retraction by a tarsal transplant from the upper lid to the lower lid. An overall effect of 2-mm improvement +/- 0.7 mm occurred. Eighty-nine percent of the lids achieved the position of the lower lid within 1 mm of the limbus. We think that the upper to lower tarsal transplant offers a technically easy and reasonable solution to moderate lower lid retraction associated with dysthyroid orbitopathy.