The best age for surgery in pediatric strabismus is selected according to different types of strabismus. In case of congenital strabismus, either internal or external strabismus, surgery should be performed as early as possible. The younger the age of surgery, the earlier the visual acuity is developing, and the establishment and recovery of stereo vision will be better; if the timing of surgery is too late, the child’s stereo vision will be difficult to establish, and surgery is generally chosen within two years of age. If the child is suffering from an adjusted internal strabismus or intermittent exotropia, he/she should first check his/her visual acuity and dilated eye examinations to see if the visual acuity of both eyes is balanced and if there are refractive errors such as amblyopia and myopia, astigmatism, etc. If there are refractive problems, he/she should first wear glasses to correct the refractive errors. If the eye position returns to normal after 3 to 6 months of glasses correction, surgery is not necessary; if strabismus still exists after 3 to 6 months of glasses correction, surgery can be performed to correct the remaining strabismus degree after wearing glasses. Generally, children under ten years old or those who do not cooperate well need general anesthesia for surgery, while children over ten years old or those who can cooperate well can undergo local anesthesia surgery. Local anesthesia surgery has certain advantages for strabismus correction, as the surgeon can check the eye position while the child is awake during surgery and adjust the amount of surgical correction to make the surgery more accurate, so for children with intermittent exotropia, they can wait until they are a little older and can tolerate local anesthesia surgery for better correction results. In conclusion, there is no clear best age for pediatric strabismus surgery, and the timing of surgery should be chosen according to the different types of strabismus, refractive status and physical condition of the child.