Epicanthal folds are small crescentic webs of skin that contour around the medial canthal region with their concavity directed towards the inner canthus. They can be seen as an isolated, or racial finding, or in association with several facial anomalies. There are four types characterised by their sites of origin and insertion on the upper and lower eyelids. Epicanthus supraciliaris originates from the upper lid and runs downwards towards the lacrimal sac. Epicanthus palpebralis originates at a lower level in the upper eyelid and also ends at a lower level in the lower eyelid. Epicanthus tarsalis arises from the upper lid and extends inferiorly but with minimal involvement of the lower lid. In epicanthus inversus, the redundant fold arises from the lower lid and extends upward along the medial canthus.