To evaluate the improvement in the tear film lipid layer (TFLL) and its subsequent impact upon corneal aberrations following intense pulsed light (IPL) treatment in patients with evaporative dry eye disease (DED) due to meibomian gland dysfunction (MGD). The prevalence of DED is common and can lead to ocular discomfort, reduced visual acuity, and lowered quality of vision (QoV) and life. In this self-control study, patients with moderate-to-severe evaporative DED due to MGD were consecutively enrolled and underwent two IPL treatments at 3-week intervals. Clinical assessments, such as Ocular Surface Disease Index (OSDI) and QoV questionnaires, anterior corneal aberrations, noninvasive tear breakup time (NITBUT), interferometric fringe pattern as determined by TFLL quality, corneal fluorescein staining (CFS), meibum gland (MG), conjunctival hyperemia (CH), best-corrected visual acuity, endothelial cell count, and intraocular pressure, were conducted at pretreatment (D-0), day 21 (D-21), and day 42 (D-42) after IPL treatment. The final analysis included 124 eyes of 62 patients (29 females, 33 males; mean age 35.66 ± 11.09 years). Clinically and statistically significant improvement in NITBUT was observed at D-42 ( < 0.01). OSDI, QoV, TFLL score, and MG quality and expressibility all improved significantly ( < 0.05) at D-42, whereas CH ( = 0.073) and CFS ( = 0.058) showed minor not significant improvements at D-42 of assessment. Anterior corneal aberrations also improved significantly at D-42 of assessment ( < 0.05). IPL treatment reduced the severity of symptoms and improved the overall tear film (TF) stability in patients with moderate-to-severe evaporative dry eye (DE) due to MGD. Additionally, the significant improvement in QoV in DE patients can be attributed to the reduction in anterior corneal aberrations due to improved TF stability.