Purpose To evaluate the results of the full rectus muscle transposition augmented with a posterior intermuscular suture for paralytic strabismus. Design Single-center, retrospective, interventional case series. Methods This study retrospectively reviewed the medical records from November 1994 to September 2004 of 16 patients who underwent the full tendon transposition that was augmented with posterior intermuscular suture for paralytic strabismus. This series evaluated the results of a single transposition surgery; five patients had previous nontransposition strabismus surgery. The following data were analyzed before and after the operation: (1) the angle of deviation in the primary position, (2) the presence of diplopia in the primary position, (3) the binocular single visual fields, (4) the presence of an abnormal head posture, (5) the motility of the affected eye, and (6) the procedure that was performed. Results The preoperative angle of deviation in the primary position was 59 ± 22 prism diopter (prism diopter; range, 30 to 115 prism diopter) compared with 17 ± 12 prism diopter (range, –10 to 40 prism diopter) after the operation. The preoperative binocular single visual fields improved from 0 degrees to 60 ± 25 degrees (range, 0 to 90 degrees) after the operation. Diplopia in the primary position was resolved in 11 patients (69%) after the operation. There were no complications such as scleral perforation, unwanted vertical deviations, or anterior segment ischemia in any of the cases during the procedure and postoperative follow-up. Conclusion Full tendon transposition that is augmented with a posterior intermuscular suture is an effective procedure that results in improved ocular alignment in patients with paralytic strabismus and has a favorable complication profile.