This report examines the persistence of many cases of accommodative esotropia well beyond the expected time of resolution (age 10 to 12 years) and the potential usefulness of any associated clinical features to predict timely or delayed disappearance. In a series of 202 patients, there was no discrete age of improvement and more than half persisted after age 10 years. The results were similar for both high and normal accommodative convergence/accommodation ratio cases. Initial hyperopia did not predict persistence; subsequent increases prior to age 7 years, and decreases thereafter, were different statistically but were clinically similar. Moreover, the occurrence of inferior oblique overaction and of dissociated vertical deviation, as well as a family history of strabismus, did not predict persistence or delayed improvement.