Aim: The aim of this study was to determine types of facial fractures that use the preseptal transconjunctival approach and to evaluate the lower eyelid condition. Materials and methods: Ninety-one patients who underwent open reduction internal fixation of facial fractures using preseptal transconjunctival approach from 2005–2013 were included and analyzed from clinical records. We evaluate the incidence of postoperative complication such as visible scar at rest, entropion, ectropion, scleral show, trichiasis, conjunctival granuloma, lower eyelid laceration, corneal lesion, and lacrimal drainage lesion. The types of facial fractures that frequently use this approach were also analyzed. Results: Four out of ninety-one patients were excluded because of insufficient data. Zygomatic complex fracture occurring in isolation or combination with other fracture was the commonest fracture type encountered (93.5%). Two complications (entropion and trichiasis) occurred in one out of eighty-seven patients. The complication rate in this study was very low at 1.1%. Conclusion: A preseptal transconjuctival approach is a versatile approach that can be used in all mid-face fracture situations providing an alternative to the invasive transcutaneous approach. It provides minimal complications with superior esthetic result. Clinical significance: The management of facial fractures that involve orbital rim or floor often poses a challenge to the surgeon because surgeons aim for complete repair of the orbital anatomy with least complication and superior esthetic result. Two surgical incisions existed in the process of reaching orbital bony component which is the transcutaneous and transconjunctival approach. It will help clinicians to know which approach provides minimal complication.