【Abstract】 Objective To analyze the surgical efficacy of weakening the overaction of superior oblique muscle in children with cerebral palsy and Apattern strabismus. Methods 16 patients with overaction superior oblique with cerebral palsy and Apattern strabismus, including 2 cases with monocular disease and 14 cases with binocular disease, 30 eyes, treated in our hospital from June 2015 to December 2016 were selected. The overaction of superior oblique muscle was weakened by lengthening its tendon. The preoperative and postoperative (halfyear after operation) strabismus angles were recorded when the patients look up or down 25°. The efficacy of the surgery was evaluated. Results 16 children took the surgery with both eyes except 2 took with one eye had only one eye with superior oblique muscle overacting. Apattern Strabismus in most patients turned to become much better or even recovered by lengthening the superior oblique muscle, with 3 patients recrudesced in varying degrees turned to be still better comparing with their preoperation situation. The success rate of the operation was 8125% (13/16). The Apattern strabismus showed obviously changed comparing with pre and postoperation (t=565，P＜005). Among all the patients, 7 children presented difference about their superior oblique muscle showed up much stronger and thicker than those in normal strabismus patients. No case had secondary superior oblique palsy or Vpattern after surgery. Conclusion The results show that the surgery of weakening the overaction of superior oblique muscle is an effective way to change the Apattern strabismus, with the individualized design for the spastic cerebral palsy patients who may have stronger muscular strength of extraocular muscles.