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AIM: To compare the overall surgical outcome of chalazion surgery under general anesthesia or local anesthesia in children. METHODS: This was a retrospective case-control study. Pediatric patients(4-year-old to 10-year-old)with bilateral chalazion who were treated with extraction surgery were included during January 2015 to December 2016. These subjects were divided into two groups according to type of anesthesia: general anesthesia group(GA group, 67 cases, 134 eyes)and local anesthesia group(LA group, 72 cases, 144 eyes). The pain score(FPS-R)and post-operative psychological destruction scores, condition of tear film and Meibomian gland, the recurrent rate and postoperative complications were recorded and statistically analyzed. RESULTS: No anesthesia-associated complication were recorded in both groups. The children in GA group felt no pain during operations. The FPS-R score at 3h after surgery in GA group was 4.94±1.23, which was significantly lower than that of LA group(7.00±1.14, PPPPPPCONCLUSION: Chalazion surgery under general anesthesia has the advantage of mild pain and good compliance in children. After surgery, the patients presented with better tear film and Meibomian gland status, and fewer complications under general anesthesia.