The most common type of overactive inferior oblique muscle is secondary to a delay in the development of superior oblique muscle function. Operative intervention is not indicated because as a child matures the overactivity of the inferior oblique muscle will gradually disappear. In those cases where surgery is performed, the desired effect of elimination of excess elevation is achieved indirectly. The theory that the inferior oblique muscle is not primarily an elevator is supported by this explanation involving an indirect surgical effect. An explanation of a common postoperative finding after unilateral recession of an inferior oblique muscle is presented.