Both the treatment and prognosis of X (T) are controversial. Some disagree about the type of surgery to be performed. The most common methods for treatment of basic exotropia are bilateral lateral rectus recession and unilateral recess- resect. There is no agreement between the surgeons about the procedure of choice in management of exotropia.This study was conducted to compare between bilateral lateral rectus recession and recess-resect procedure in the management of alternating exotropia of the basic type as regards efficacy, long term stability as well as the creation of symptomatizing significant lateral incomitance. The success rate in both groups was identical 75%. This study shows no difference between bilateral lateral rectus recession and unilateral recess- resect procedure in the management of basic type of alternating exotropia regarding motor success, sensory success or producing significant lateral incomitance in side gaze.