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Purpose. To evaluate the distribution pattern and changes of strabismus surgery in children based on the data collected from a local eye hospital in the south of China between 2006 and 2011. Methods. A retrospective analysis of all strabismus surgeries in children ( Result. A total of 2,219 strabismus surgeries were performed during the study period, with concomitant exotropia (44% of all surgeries) more than esotropia (27%, χ2=42.7, p<0.001). Total number of surgeries increased from 250 in 2006 to 508 in 2011, with a significant increase in concomitant exotropia: 38% of all surgeries in 2006 increased to 47% in 2011 (χ2=29.4, p<0.001). The increase of intermittent exotropia was approximately 26% of all increments of strabismus surgery between 2006 and 2011. Conclusion. Surgery for childhood exotropia was more frequent than esotropia in China. The proportion of exotropia progressively increased, while the proportion of esotropia decreased during these years. Intermittent exotropia was the main increment of strabismus surgery. Further population-based studies are needed to confirm the proportion of surgery and whether the incidence of strabismus surgery increased in China.