Background: Xanthelasma palpebrarum (XP) is a recurrent cutaneous xanthoma characterized by yellowish plaques on the eyelids resulting from the deposition of cholesterol-laden histiocytes. There are numerous modalities for treating XP, but there is no conclusive consensus on the single best treatment. Objectives: We aimed to investigate the clinical findings of Korean XP patients and assess the efficacy of 100% trichloroacetic acid (TCA) in treating XP. Methods: We retrospectively reviewed the clinical and post-procedural findings of 34 patients with XP who received TCA peeling. Results: As reported in the previous studies, the patients were female-dominant (70.6%) and the majority of them (67.9%) had dyslipidemia with average total cholesterol of 200.9 mg/dL. Half of the patients (54.8%) experienced recurrence of XP, and age was a sole significant negative predictor of recurrence (OR=0.883, p=0.048) while dyslipidemia, disease grade, and location of the skin lesions were all irrelevant. There were no side effects involved with TCA peeling such as ulcer, scarring, and hyperpigmentation. Conclusion: Dyslipidemia was the most frequent associated finding in patients with XP. The recurrence of the disease, however, does not seem to be affected by dyslipidemia. Considering the recurrent nature of the disease, we suggest TCA peeling as a safe and effective treatment modality for XP with minimal side effects and convenience for both the clinicians and the patients.