In pediatric strabismus surgery, the most common complication of extraocular muscle manipulation is oculocardiac reflex (OCR) , and the most common clinical manifestation of OCR is sinus bradycardia, but various arrhythmias even cardiac arrest may occur. The cardiac output in children is heart rate-dependent, and the cardiac output cannot be increased by increasing the myocardial contractility, but can only be increased by increasing the heart rate, so the impact of bradycardia on the body is greater than that of tachycardia. This article reviews the physiological mechanism, risk factors, prevention and treatment measures of OCR during pediatric strabismus surgery, and has certain clinical guiding significance for the prevention of OCR during pediatric strabismus correction through the understanding of the risk factors related to surgery and anesthesia.