BACKGROUND: Intraoperative oculocardiac reflex (OCR) is a common problem of pediatric strabismus surgery and potentially fatal as it can cause cardiac arrest. The goal of this study was to assess the effects of gallamine, vecuronium and rocuronium on the oculocardiac reflex, blood pressure and heart rate in pediatric strabismus surgery. METHODS: Ninety healthy children undergoing strabismus surgery were randomly assigned to three groups; gallamine, vecuronium or rocuronium group. All children were under general anesthesia induced with thiopental sodium and received gallamine 3 mg/kg, vecuronium 0.1 mg/kg, or rocuronium 0.8 mg/kg as a muscle relaxant, and were maintained with sevoflurane in 50% nitrous oxide. Systolic blood pressure, diastolic blood pressure, and heart rate were measured before anesthesia, before the operation, before traction and after traction of the ocular muscle. The OCR was defined as a 20% or greater decrease in heart rate from before traction of the ocular muscle. RESULTS: Compared with three groups, there were decreased incidences of OCR and increased heart rate at before the operation, before traction and after traction in the gallamine group (P<0.05). Systolic blood pressure and diastolic blood pressure were no differences occurred among three groups. CONCLUSIONS: We found that the gallamine group results in decreased incidences of OCR and increased heart rate were comparable with three groups.