Strabismus in high myopia is an acquired strabismus in eyes with axial high myopia. It is characterized by acquired esotropia associated with hypotropia and restricted abduction and elevation. Effect of several surgical treatments for it is still controversial. The complicated etiology needs to be further discussed. We reported two cases of myopic strabismus fixus that were treated with two diffrent surgical procedures. One case was treated by a loop myopexy of the lateral rectus ( LR) and superior rectus (SR) muscles, the other was treated by a partial Jensen’s procedure (superior arm only) . Two surgical procedures are effective for highly myopic strabismus.Also we described the results of pathologic analysis of extraocular muscle and biceps brachii.