Pediatric lopsided neck, commonly known as “pediatric lopsided neck disease”, is a relatively common disease in children. There are various causes of the crooked neck, so we need to clarify the nature before treating it. There are several common types of pediatric lopsided neck in clinical practice as follows. 1. Congenital myotonic squint: It is a pediatric squint caused by contracture of the sternocleidomastoid muscle on one side. It is the most common type of pediatric lopsided neck and can be treated conservatively before 1-2 years old, and requires surgery after 1-2 years old. 2. Bony squint: It is due to abnormal development of the child’s cervical vertebrae, such as cervical fusion, cervical hemivertebral deformity, abnormal connection between cervical vertebrae and skull base. In this kind of slant neck, the child’s neck will have restricted movement and inflexible neck rotation. An X-ray or CT scan of the cervical spine is needed to aid in the diagnosis. Treatment of bony squint is more difficult, the risk of treatment is higher and the effect is sometimes less satisfactory. 3. Ophthalmic squint: It is a skewed neck caused by eye diseases such as eye muscle paralysis, strabismus, and internal vision (commonly known as “fighting eyes”). In general, the problem of crooked neck will disappear after the eye disease is cured. However, some children need some follow-up auxiliary treatment (including surgery) to gradually return to normal. 4. Acute squint: Also known as “inflammatory squint”, this is a squint caused by inflammation of the neck. In this type of squint, the child’s head and neck are normal before the onset of the disease, and the occurrence of squint is sudden. Common causes are: lymphadenitis of the neck, abscesses of the throat wall, tuberculosis of the vertebral body, tumors of the vertebral body, etc. The most common of these is a subluxation of the cervical spine, which is now also called a rotational displacement of the cervical spine and is similar to a “drop pillow” but different in nature from a “drop pillow”. It is caused by the inflammation of the neck invading the joints or ligaments of the cervical spine, resulting in the displacement of the cervical spine, and a cervical spine opening film or a 3D CT examination of the cervical spine is required to make a clear diagnosis. This kind of slanting neck needs timely and effective treatment, such as: cervical brace protection, pharyngeal inflammation anti-inflammation, neck traction, etc. 5.Neurological squint: squint caused by intracranial tumor, spinal cord cavitation, etc. It is relatively rare and belongs to neurosurgical treatment, and requires corresponding treatment by neurosurgeons. 6.Spastic squint: Squint caused by muscle spasm in the neck, the cause is unknown, rare, not easy to examine and diagnose, and there is no good method for treatment. 7. Habitual squint: The squint that exists after excluding the above mentioned organic lesions caused by the squint is called habitual squint, that is to say, the child has had many examinations, but, never found a cause for the squint, then it may be habitual squint, but it is easy not to make the diagnosis of habitual squint because it is possible that the underlying cause has not been found yet. The different nature of the squints need to be treated accordingly, and the diagnosis needs to be clarified first.