Objective: To observe the effects of nerve growth factor (NGF) on the treatment of acquired paralytic strabismus. Methods: In this prospective clinical study, 73 patients with acquired paralytic strabismus were reviewed between January 2012 to December 2014 at Tianjin Medical University General Hospital.They were divided into 2 groups depending on whether or not NGF was used. There were 45 patients in the combined NGF group and 28 in the semplice mecobalamin group. Conservative treatment was used in the two groups. Patients in the combined NGF group were injected intramuscularly with 18 μg of NGF and 500 μg of mecobalaminonce a day for 4 weeks. Those in the semplice mecobalamin group were injected by the same method with 500 μg of only mecobalaminonce a day for 4 weeks. Curative effects were estimated at the end of treatment and 3 months after treatment. Differences between the two groups were determined using chi-square tests. results: There was a significant difference in the cure rate and effective rate between the 2 groups at the end of treatment (cure rate: 67% vs. 43%, effective rate: 89% vs. 68%) ( χ 2 =4.005,P=0.045; χ 2 =4.926, P=0.026), and 3 months after treatment (cure rate: 87% vs. 46%, effective rate: 98% vs. 75%) ( χ 2 =13.638, P<0.001; χ 2 =9.177, P=0.002). In addition, the cure rate in the combined NGF group at 3 months after treatment was significantly higher than at the end of treatment (P=0.001). There was no significant difference at 3 months for the semplice mecobalamin group (P=0.711). conclusions: The curative effect of mecobalamin with NGF is superior to semplice mecobalamin alone for the treatment of acquired paralytic strabismus. In addition, the NGF treatment has long-term effects.