The study involved 40 children. After induction of anesthesia children were randomly allocated to 2 groups 20 child each. The 1st group is the control group and received general anesthesia alone (group A) and the 2nd group received general anesthesia combined with Peribulbar block (group B). This study evaluated the effectiveness of peribulbar block on intraoperative incidence of the OCR, hemodynamic responses, postoperative analgesia and the immediate PONV in children undergoing strabismus surgery under general anesthesia. During the intraoperative period, peribulbar block showed lower reduction of heart rate (24.0±2.8%) compared to the control group (39.3±5.7%, p = 0.004). Two patients (10%) of peribulbar group and 14 patients (70%) of the control group (p < 0.001) developed OCR. Atropine treatment was needed in only one patient of the peribulbar group and 4 patients (20%) of the control (p = 0.342). Arrhythmias were recorded in 3 cases (15%) of the control group and was absent in peribulbar group (p = 0.231). Postoperatively, peribulbar block resulted in a significantly better analgesic effect and lower frequency of PONV. In conclusion, peribulbar block was an effective adjuvant to general anesthesia in children undergoing strabismus surgery. It significantly reduced the frequency of intraoperative OCR. Postoperatively, it provided a better degree of analgesia especially on awaking and prevented significantly the development of nausea and vomiting.