A retrospective study was conducted of superior oblique (SO) tuck as a primary and secondary surgery over a 25-year period involved 162 eyes of 162 patients. Two thirds were male. Mean age at surgery was 45.94 years. The left eye was involved in 52.5% of cases; two thirds were of congenital aetiology. All had preoperative diplopia. Mean follow-up was 7.5 months. The preoperative deviation measured 15.88PD on average reducing to 5.09PD postoperatively. Ninety-seven percent achieved a postoperative reduction in angle. Postoperative Brown’s syndrome was noted in 24 patients but only two needed corrective surgery. One third of patients required a second surgical procedure. Eight percent had complete resolution of diplopia. No linear relationship was found for tuck size and surgical outcome. The authors conclude that SO tuck is an effective and uniform treatment option.