Objective: To evaluate the results of intraoperative adjustable horizontal strabismus surgery under topical anesthesia. Material and Methods: Twenty-two cases with horizontal strabismus who applied to our clinic between June 2005 and December 2006 were included in this study. Exotropia was present in 14 patients and esotropia in 8 patients. The mean age of patients was 21.08 (16-34). Preoperative diplopia test was performed in all patients to determine postoperative target deviation degree. The patients who had postoperative target deviation less than 10 prizm dioptri and no diplopia was considered success. Results: A total of 22 patients were studied. Eighteen patients underwent adjustable recession and 4 patients received adjustable resection surgery. The surgical success was achieved in 20 (90.9%) patients at postoperative first week and in 19 (86.3%) patients at postoperative third and sixth months. Postoperative diplopia was not observed in any of the cases. Intraoperative and postoperative serious complications were not observed but peroperative pain and discomfort were observed in adjustable resection surgery. Conclusion: Adjustable horizontal strabismus surgery under topical anesthesia was quite effective and reliable method but adjustable resection surgery can cause serious discomfort and pain.