The ideal approach to the management of intermittent exotropia remains unclear. Well designed, prospective studies are limited. Furthermore, the criteria for success vary among health care professionals. Long-term outcomes of surgical intervention are not known, and the role of non-surgical treatment modalities has not been agreed upon. A multicenter study comparing surgical and nonsurgical treatment method has been proposed. If carried out, a study of this nature would greatly benefit many individuals affected by this common condition. Until then, intermittent exotropia will continue to be one of the most difficult problems to treat.