The efficacy of eye muscle surgery for strabismus in patients with myasthenia is not well-documented in the literature. We reviewed the results of strabismus surgery in six patients with the confirmed diagnosis of myasthenia. Patients selected for surgery had angles of deviation that were stable for at least 5 months preoperatively. Patient age ranged from 4 to 62 years. All patients were exotropic. The four adults had moderate limitation of adduction. Surgery included horizontal rectus muscle recession and/or resection in all cases. Three cases involved additional surgery of the vertical rectus or superior oblique muscles. The mean postoperative follow up was 44 months with a minimum of 7 months. Three adults and one child achieved stable satisfactory alignment after one procedure. One child required three procedures to achieve satisfactory alignment. The results suggest that surgery is a viable option in the management of strabismus in selected patients with myasthenia.