Objective To explore clinical characteristics and treatment efficacy in children patients with acute acquired concomi-tant esotropia.Design Retrospective case series.Participants 31 children patients with acute acquired concomitant esotropia between Jan 2019 and Oct 2022 in Xijing Hospital.Methods The different categorization data,including strabismus degree,stereopsis,and treatment plan were reviewed.Onset age,strabismus degree,visual function,treatment outcomes in different subgroups according to the Burian and Miller classification was compared.Main Outcome Measures strabismus degree and near and distance stereopsis before and after treatment.Results There was no difference in the far and near strabismus degree between type Ⅱ patients(n=19)(P>0.05),while type Ⅲ patients(n=12)had a higher onset age than type Ⅱ patients(P<0.05)with a lower near strabismus degree than the far strabismus degree(P<0.05).There was no difference in strabismus degree and stereopsis between type Ⅱ and Ⅲ patients(P>0.05).After botulinum toxin injection and strabismus surgery,the degree of strabismus can be significantly reduced and visual function can be im-proved.Conclusion Acute concomitant esotropia in children can occur in types Ⅱ,and Ⅲ,with type Ⅱ being more common.Type Ⅱpatients are younger with the similar degree of far and near strabismus degree.Type Ⅲ patients are older with a lower near strabismus degree than far strabismus degree.Acute concomitant esotropia patients with different types have visual function abnormalities and need to be treated as early as possible,which can lead to a better therapeutic effect.(Ophthalmol CHN,2024,33:218-222)