OBJECTIVE： To observe therapeutic efficacy and safety of tobramycin dexamethasone in the treatment of meibomian gland dysfunction （MGD）. METHODS： 108 MGD patients were randomly divided into control group （53 cases） and observation group （55 cases）. Control group was given eyelid cleaning with conventional physical cleaning method， at the same time， given Doxycycline hydrochloride tablets 0.1 g orally after meal， twice a day. Based on control group， observation group was additionally given Tobramycin and dexamethasone eye ointment with length of 1.0-1.5 cm， smearing into conjunctival sac， 4 times a day. Treatment courses of 2 groups lasted for 4 weeks. Clinical efficacies of 2 groups were observed as well as eyelid observation score， symptom score， the levels of IL-6 and TNF-α， the occurrence of ADR before and after treatment. RESULTS： The total response rate of observation group was significantly higher than that of control group（89.1％ vs. 77.4％）， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in eyelid observation score， symptom score， the levels of IL-6 and TNF-α between 2 groups （P＞0.05）. After treatment， eyelid observation score of 2 groups were significantly higher than before treatment， and the observation group was significantly higher than the control group； symptom score and the levels of IL-6 and TNF-α in 2 groups were significantly lower than before treatment， and the observation group was significantly lower than the control group， with statistical significance （P＜0.05）.There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）.  CONCLUSIONS： Based on routine treatment， tobramycin dexamethasone shows significant therapeutic efficacy for MGD， and can improve clinical symptoms significantly but does not increase the occurrence of ADR.