Objective To explore the incidence of postoperative diplopia of strabismus.Methods Retrospective case series study. Medical records of 5900 patients between Jan 1999 and Dec 2009 underwent strabismus surgery were studied. Incidence of postoperative diplopia of strabismus,surgical age and strabismus type were analyzed, and surgical principle and design ideas were optical reflection normotopia when adult exotropia surgeries were done, and retain a small amount of amount of surgery for a muscle to avoid eye movement limited, and diplopia occurred. Binocular vision training was taken with synoptophore post surgery. Only 555 cases (9.41%) were complaints of diplopia post surgery in 5900 cases of strabismus surgeries, in which patients with transient diplopia were 552 cases (9.36%), diplopia completely disappeared after 3 days, 1 week or 1 month,and persistent dipiopia were 3 cases (0.05%), the symptoms persisted for 0.5-2.5 years. The incidence of postoperative diplopia of concomitant exotropia reached 12.58% (433/3443), make a contribution to the total rate for 78.02%. There was little relationship between age and incidence of diplopia. Conclusion Intractable diplopia after strabismus surgery is very rare, when patients who have temporary diplopia receive the synoptophore training and psychological intervention.