Brown’s syndrome, also known as superior oblique tendon sheath syndrome or Janesch Brown syndrome is characterized by limitation of elevation in adduction with divergence in up gaze, and a normal elevation in abduction. The term Brown’s plus is used when superior oblique overaction is present along with Brown’s syndrome. The syndrome can be congenital or acquired, and a large number of causes have been attributed for the same. Various management options include complete tenectomy of superior oblique, superior oblique recession, tendon lengthening procedures and split tendon lengthening.