Purpose: To describe the incidence, aetiologies and follow-up of patients with paralytic strabismus. Methods: This retrospective study included 193 strabismic patients with isolated III, IV or VI cranial nerve palsy, cases of the strabismus, from the Department of Ophthalmology of tertiary care center in western central India between January 2007 and December 2020. The present study analysed the injured cranial nerve, the affected eye, sex distribution, aetiology and follow-up. Results: About

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... 7% of the cases were congenital, and 16.1% were in the paediatric age group. The VI cranial nerve was the most frequently affected (56.5%) in these cases. The incidence was higher in males (58.1%) than females. Trauma was the common cause of III (7.1%), IV (8.3%) and VI (50%) nerve palsy. The disease management modalities included surgical, medical and spontaneous resolution.Conclusions: The sixth cranial nerve was affected most frequently. However, the most common underlying cause was yet undetermined.