The optimal time for surgery for intermittent exotropia is before the development of constant strabismus and abnormal retinal correspondence, usually at the age of 4 to 6 years. The clinical features of intermittent esotropia are that it occurs early but is detected late. Therefore, once the diagnosis of intermittent esotropia is confirmed, certain interventions are required to prevent the development of a constant esotropia and an abnormal retinal correlation. If the child is too young, the visual acuity and control should be followed up regularly, and surgery can be performed when the control has been evaluated above a certain threshold or at around 5 years of age. Children between 4 and 6 years of age are more cooperative and are better able to cooperate with strabismus examinations and surgical treatments, which allows for a better combination of surgical results and prevents strabismus from progressing in a worse direction. It is recommended that the timing of surgery should be determined by a comprehensive evaluation of the individual’s development of strabismus and age factors, and then selected by the surgeon’s recommendation.