To summarize and analyze the diagnosis, treatment protocol, and therapeutic effect of orbital hypertelorism in the past 30 years in our center. This retrospective study reviews the records of 128 patients from 1978 to 2008. Both radiologic measurements, such as the interorbital distance and the outer orbital distance, and anthropometric measurements, such as the width of the inner canthi (W-IC), the width of the palpebral fissure, the width of the face, and the nasofrontal angle, were conducted before and after the operation to evaluate both osseous and soft tissue alteration. An analysis of the etiology, surgical method, and complication has been undertaken. The main cause of orbital hypertelorism in our center was craniofacial cleft. Significant improvement in cranio-orbital appearance was noted, and 91.4% of the patients were satisfied with the surgical correction. Follow-up examinations showed a statistically significant difference between preoperative and postoperative measurements: interorbital distance; outer orbital distance; facial ratios W-IC/width of the palpebral fissure and W-IC/width of the face (P < 0.01); and nasofrontal angle (P < 0.05). Temporary complications and side effects remained low, with cerebrospinal fluid leakage occurred as the major complication (6.3%). There are several important protocols regarding the management of orbital hypertelorism that will provide patients with great benefit in achieving more aesthetic facial appearance.