This study aimed to compare the effectiveness of the two surgical methods on the correction of inferior oblique over action (IOOA). This was a retrospective study of 99 eyes of 56 patients; 47 myectomy and 52 anterior transposition procedures. Mean age was 5.9±6.5 years with 60% female. Bilateral surgery was undertaken for 44 cases (20 myectomies). There was no difference between groups preoperatively. Postoperatively after adjustment for preoperative grading values, there were no significant differences between groups: efficacy of each procedure in weakening the IO was similar. Satisfactory results were obtained for 61.7% myectomy and 67.3% anterior transposition. They found that dissociated vertical deviation (DVD) and hypertropia were also corrected similarly by the two procedures.