The epicanthal fold is a semilunar flap of eyelid skin on the medial aspect of the eye. Many surgical techniques have been described to eliminate the epicanthal fold, which is a feature uniquely predominant among the Asian population. However, many surgeons avoid epicanthoplasty because of the fear of visible scar formation. From January of 2002 to April of 2004, 118 patients with medial epicanthal folds underwent epicanthoplasty using a periciliary Y-V advancement procedure for the prevention of visible scar formation. The mean age of the patients was 25.2 years (range, 16 years to 56 years). The median follow-up period was 6 months (range, 2 weeks to 2 years). We performed periciliary Y-V epicanthoplasty only when a patient had wide interepicanthal distance (over 32 mm) or a completely eclipsed lacrimal caruncle. Most of the patients attained satisfactory results, and there were few complications in our cases. Scarring of the medial canthal area has not been a problem with this technique because we designed incisions along the eyelashes and skin-mucosal junctions. We have found that our periciliary Y-V epicanthoplasty is a very reliable and effective method for eliminating the epicanthal fold with minimal scar formation.