This study was designed to determine the success rate among patients with consecutive exotropia after choosing an appropriate surgical method based on medial rectus function and level of exo deviation. The authors conducted an interventional case series study of 40 consecutive cases of exotropia. The mean deviation preoperatively was 29±13PD reducing to 7±7PD at a minimum three month follow-up. Surgical success at <8PD was achieved in 77.5% of cases: 83.3% with medial rectus resection, 81% with lateral rectus recession and 57.1% in combined surgery. The preoperative amount of exo deviation was the only risk factor of surgical failure in this study.