Ocular Demodex infection can cause discomfort of the ocular surface and a variety of ocular conditions, and the incidence has been increasing in recent years. Tea tree oil and its derivatives not only have significant acaricidal effect, but also have antibacterial and anti-inflammatory activities, and are commonly used in the treatment of Demodex eye disease. Currently, various kinds of preparations from tea tree oil are available, yet the safety and optimal use of the related extract have not been fully clarified. This paper reviewed the mechanism, application, safety and efficacy of tea tree oil in the treatment of Demodex eye conditions, with an attempt to provide reference for clinical use of this extract for ocular Demodex infestation.