The authors report a modified Jenson procedure for the treatment of high axial myopic esotropia. Their study includes 15 eyes of 13 patients with a mean age of 50±10.4 years. Mean spherical refraction was -22.53±6.06 dioptres. Mean axial length was 30.03±5.65mm. Immediately postoperatively 12 eyes were aligned in primary position, two eyes had 5-10 degrees of esotropia with <5 degrees of hypotropia, and one eye had 15 degrees esotropia with 5 degrees hypotropia. One patient regressed and required a second surgical procedure. At six months follow-up, results were available for 10 eyes of nine patients. Six eyes were aligned in primary position, one eye had 10 degrees esotropia with 5 degrees of hypotropia, one eye had 15 degrees esotropia, and two eyes had 15 degrees esotropia with 5 degrees of hypotropia. The surgical modification involved union of the superior and lateral rectus muscles performed without splitting them into two beams with union using two pairs of sutures at approximately 12 and 14mm posterior to the muscle insertions. All patients showed significant improvement in alignment and motility.