Objective  To investigate the long-term surgical outcome of unilateral lateral rectus recession for small-to-moderate angle intermittent exotropia in children. Methods  Sixty-nine children with intermittent exotropia (15△-35△) who underwent unilateral lateral rectus recession during April 2009 to March 2010 were retrospectively reviewed. The exodeviations were measured by the alternate prism cover test at both distance (6 m) and near (33 cm) with fixation on accommodative targets. An amount of 7-10 mm unilateral lateral rectus recession was performed according to the quantity of distance deviation. The Worth 4-Dot test was employed both at distance and near fixation to assess central and peripheral fusion， respectively. The Titmus stereo test was used to assess stereoacuity. A successful alignment was defined as -8△-0△ in primary gaze while viewing distant and near targets. There was a minimum of 6 months follow-up period. Incomitance was defined as a change of more than 10△ from primary to lateral gaze. The data were analyzed with a chi-square test. Results  The successful rates in alignment at 1-3 days postoperative and final follow-up periods were 81% and 62%， and the undercorrection rates were 12% and 36%， respectively. The patients who underwent an amount of 9.5 mm and 10 mm unilateral lateral rectus recession had a higher undercorrection rate at the final followup. The number of patients with normal central fusion， peripheral fusion and stereoacuity at final examination increased statistically compared to the preoperative number (χ2=21.9， 14.0， 15.0， P<0.01). None of the patients had clinically significant lateral incomitance at the final followup. Conclusion  Unilateral lateral rectus recession is a safe and effective treatment for intermittent exotropia in children with exodeviation measuring 15△ to 25△.