Six overweight patients, five men and the first woman to be reported, are described with floppy eyelid syndrome. Five patients had bilateral ocular involvement. Only two patients were free of other ocular surface problems. Concurrent diagnoses included blepharitis, keratoconjunctivitis sicca, lagophthalmos, medicamentosal conjunctivitis, molluscum contagiosum, and masquerade syndrome. Five patients responded to appropriate therapy, which included shielding the eyes during sleep. Three patients underwent a horizontal lid tightening procedure, which resulted in permanent correction of their floppy eyelids and resolution of their ocular signs and symptoms.