Objective To investigate the effect of a modified Yokoyama′s technique in the treatment of fixus strabismus with high myopia. Methods A retrospective analysis was conducted on the medical records of 8 eyes of 6 patients with myopic fixus esotropia who underwent the modified Yokoyama′s surgery between 2011 and 2014. The location of the extraocular muscles was investigated with CT scan. Ocular alignment and motility in the nine diagnostic gaze positions were evaluated pre- and postoperatively. A forced duction test was also performed during the operation. Modified Yokoyama′s surgery and the medial rectus muscle recession were performed to correct eye position. Results The scans showed that the position of the extraocular muscles had changed， and restricted abduction and elevation were detected by the forced duction test in the affected eye before surgery. The modified Yokoyama′s surgery was successfully performed on eight eyes of six patients with fixus myopic esotropia. Orthotropia in the primary gaze position was achieved in all operative eyes after 6 months of follow-up. Complications of anterior segment ischemia did not occur. Conclusion The modification of Yokoyama′s technique is a good surgical choice for treatment of myopic fixus esotropia.