Background: Strabismus is one of the most frequent eye conditions influencing a considerable percentage of children and could cause severe medical and psychological burdens. Aim: To determine the prevalence of strabismus and its types in pediatric patients and the outcomes of different treatment modalities in a referral eye center in Upper Egypt during a 3 years period. Patients and Methods:This is an observational cross-sectional study that was carried out on pediatric cases attending a large private referral ophthalmology center in Assiut City, Upper Egypt during the period of 3 years (January 2018 to December 2020). All pediatric patients (3-15 years) were included and cases with different types of strabismus were subjected to full history taking, full ophthalmic examination and cyclopedic autorefraction. Results: A total of 1356 pediatric patients attended the center during the study period. Cases with different types of strabismus were 561 cases with a prevalence of 41.4%, about two-thirds of them (66.3%) were rural and 60.0% were in the age group of 3-6 years.Esotropia was found in 54.3%, latent squint in 33.7% and pseudo strabismus in 6.4%. Surgical correction was used in treatment of 42.6% of cases with satisfying outcome in 97.6% of them. Conclusion: The prevalence of strabismus in the pediatric population attending the referral eye center was 41.4%, which was extremely higher compared to other studies and this prevalence was higher in rural areas than in urban ones and in the age group of 3-6 years than in the other age groups in the pediatric period.