To report a unique surgical approach for congenital double elevator palsy with sensory exotropia.A 7-year-old boy with congenital double elevator palsy and sensory exotropia was managed surgically by Callahan's procedure with recession and resection of the horizontal recti for exotropia without inferior rectus recession, followed by frontalis sling surgery for congenital ptosis.Favourable surgical outcome was achieved without any complication.