AIM: To evaluate the efficacy of surgical treatment of cataract with sensory exotropia. METHODS: In a prospective, consecutive clinical trail, 79 cases who had cataract with sensory exotropia accepted phacoemulcifiation and intraocular lens(IOL) implantation. The best-corrected visual acuity(BCVA), eye position, binocular visual function and diplopia condition were observed preopetatively and postoperative 1 month, 3 months. Correlation analysis was done on eye position improvement, diplopia and causes for sensory exotropia. RESULTS: BCVA of 48 cases were above 0.3, 31 cases above 0.5 and only 8 cases below 0.02 at 1 month postoperatively. 53 cases had normal eye position and acquired different degree of binocular function 1 to 3 months after operation. Diplopia of 30 cases disappeared at 3 months postoperatively. Patients with sensory exotroia due to cataract simply had more improvement in BCVA, eye position and binocular function than those due to other diseases. CONCLUSION:Patients who have cataract with sensory exotropia should accept surgical treatment of cataract first. The eye position and binocular function can be improved after operation.