Acquired esotropia in cerebellar disease is well described but under-recognised. The pathogenesis of cerebellar esotropia is controversial. It is suggested it may be a result of disruption to central vestibular pathways. This article reports a case series of seven adults with diplopia secondary to cerebellar dysfunction. The authors describe a deterioration of cerebellar esotropia over time. This has not previously been reported. All the patients were initially diagnosed with lateral rectus paresis, the diagnosis being revised after examination showed no slowing of abducting saccades and full abduction with gaze evoked nystagmus. The authors aim was to demonstrate that diplopia due to cerebellar esotropia can be the first manifestation of the underlying disorder and as such the condition may be misdiagnosed. This is something for clinicians to bear in mind when assessing patients with newly acquired symptoms.