ObjectivesThis meta-analysis aimed to compare the efficacy of botulinum toxin (BTX) injection versus surgery for acute acquired concomitant esotropia (AACE).MethodsPubMed, Embase, Web of Science, China Biomedical Sinomed, and the Cochrane Library were systematically searched for studies comparing BTX and surgery in AACE. The primary outcome was motor success rate, and secondary outcomes included stereopsis recovery and incidence of permanent exotropia. Random-effects models were applied. Sensiti