The authors reviewed the long-term outcomes of medial rectus (MR) recession alone for Mobius sequence. This was a retrospective review. Surgery involved recession of 4-6.5mm plus inferior transposition if needed for V pattern. Success was defined as within 8PD of ortho. Five patients were reviewed with moderate / marked limitation of abduction in either eye. Preoperative esotropia measured 2-30PD. Three were treated for amblyopia. All had positive forced duction test and surgery was at ages five to 14 months with follow-up of four to 19.5 years. Final surgery was successful for all with each patient obtaining binocular vision of varying degree. The results indicate that bilateral MR recession alone can effectively treat moderate esotropia in Mobius sequence with stable results long-term.