The authors developed a Persian version of the AS20 questionnaire and used the new version to evaluate the effect of strabismus surgery on health-related quality of life. Two independent bilingual translators translated the English version AS20 into Persian. The two translations were then merged into one by an expert committee. The new translation was then translated back into English by two independent bilingual translators who were not aware of the original AS20 version. The expert committee compared the translations with the original questionnaire, resolved differences and prepared the final version which was evaluated and validated in a pilot study for test-retest and internal consistency methods. A total of 112 patients with strabismus completed the questionnaire before and after strabismus surgery. High test-retest and good to excellent ranges were obtained for internal consistency. Median total psychosocial and functional postoperative scores were significantly better than preoperative scores. Females had significantly poorer scores than males and the authors propose strabismus surgery may have greater benefit in improving health-related quality of life for female patients. Overall they conclude this version may be appropriate for evaluating health-related quality of life of Iranian patients with strabismus.