Background: The magnitude of vertical deviations among strabismus patients is not small, but it is underdiagnosed in most general ophthalmic clinics. It is diagnosis and intervention are important to prevent deep amblyopia and poor vision. Objectives: The objectives of this research are to study the magnitude of vertical deviations among strabismus patients attending MAKKAH Eye Complex, Squint clinic, to determine various etiological factors and make a suitable plan of management. Methods: It is across-sectional descriptive-hospital-based study at MAKKAH eye Complex, Khartoum, Sudan, in a period of 1 year, from November 2012-November 2013. This study included 102 patients, who presented to MAKKAH Eye Complex, Squint clinic, with vertical deviation or associated with horizontal deviations. The patients were directly interviewed through a case report sheet, refraction and orthoptic examination were done for each of them. Result: Vertical deviation represents 0.15% of all strabismus patients, eighty-seven percent were below 16 years of age,12.7% were above 17 years of age, the female number was a little more than male. 3/4 of patients were children with early onset of deviation in the majority of them. Positive family history in more than half of the patients. The majority of patients presented with inferior oblique overaction with esotropia,e the commonest form was combined vertically with horizontal deviation. They represent 2/3 of patients with vertical deviations. Conclusion: The commonest type of vertical deviation was combined vertically with horizontal deviations. Hypertropia is presented more than 75% of patients with vertical deviation. Surgery and spectacles represent the most suitable plan of management.