The medial canthus comprises three limbs and functions to maintain the shape of the eye and to assist in drainage of the lacrimal sac. Repair of the medial canthal tendon is often complicated by canthal drift, extrusion of wires or sutures, and in-fracture of the contralateral orbital bones from pressure by transnasal wires. A technique used successfully for more than 25 years with a low rate of complications is described in a stepwise manner. The long-term outcomes of using this technique are reviewed. Thirty-three patient charts were reviewed. The mean age of patients was 22.4 years (range, 3 to 59 years). The surgical indications were trauma, neoplasm, and congenital deformity. Only 2 cases of canthal drift were noted after this procedure and were corrected with the same technique without recurrence. Traditional methods of medial canthopexy frequently result in complications; the technique described eliminates most if not all of these.