One hundred forty-five consecutive frontalis suspension procedures performed during the years 1976 to 1982 at the Wills Eye Hospital for the repair of congenital ptosis were reviewed. Results with nylon polyfilament cable-type suture ( Supramid Extra) as the suspensory material were compared to results with allogenic fascia lata. Forty-nine of the 121 polyfilament cable-type suture procedures (40.5%) were considered failures either because of ptosis recurrence (28.1%) or granuloma formation (12.4%). Only two of 24 (8.3%) of the fascia lata cases failed. No granuloma was associated with the use of fascia lata. The clinical and pathologic characteristics of ptosis recurrence and suture-rejection granuloma formation are discussed. Available preparations of allogenic fascia lata are reviewed and suggested as alternatives to the use of nylon polyfilament cable-type sutures for the repair of congenital ptosis.