PURPOSE: To determine the effect of unilateral large lateral rectus recession on head turn and horizontal ocular deviation in patients with unilateral exotropic Duane retraction syndrome. METHODS: This was a prospective, interventional study of 10 consecutive patients with unilateral exotropic Duane syndrome associated with contralateral head turn operated on from May 2011 to April 2014. All Patients underwent large (8.5-10mm) unilateral lateral rectus recession on the affected eye. All patients were followed for at least 6 months. Pre- and post-operative ocular deviation, angle of head turn, stereoacuity, severity of limitation in abduction and adduction were recorded and analyzed. RESULTS: Mean age of patients was 7.9±2.33 years. Female-to-male ratio was 1.5 (6:4). The left eye was involved in 8 of the patients (80%). Mean head turn decreased from 30.5˚± 9.56˚ (range, 15°-40°) to 6.5 ± 4.74° (range, 0°-15°) (P value