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To determine the prevalence of conjunctivochalasis and its determinants in a middle-aged Iranian population.This population-based study was conducted in the context of the second phase of Shahroud Eye Cohort Study in 2014. Of 4,737 participants aged 45 to 69 years who participated in the second phase, the data of 4,702 participants were available for this report. A diagnosis of conjunctivochalasis was made based on the physician's judgment on ophthalmic examinations.Diagnosis of conjunctivochalasis in at least one eye was confirmed in 295 (6.2%) participants. The prevalence of unilateral and bilateral conjunctivochalasis was 0.7% and 5.5%, respectively. Older age (odds ratio [OR] = 1.96, 95% confidence interval [CI]: 1.22–3.15), use of Losartan (an angiotensin II receptor antagonist) (OR=1.47, 95% CI: 1.05–2.08), Meibomian Gland Dysfunction (OR=2.32, 95% CI: 1.78–3.03), Pinguecula (OR=0.57, 95% CI: 0.42–0.77), and blepharitis (OR=0.24, 95% CI: 0.07–0.77) had a significant association with conjunctivochalasis.The prevalence of conjunctivochalasis in our study was less than other reports from Asian population. Conjunctivochalasis has a significant association with some eyelid disorders and the use of Losartan which should be noted when diagnosing and treating this disease.