Purpose:  To compare the accommodation convergence per accommodation ratio (AC/A) in true and simulated divergence excess exotropia. Study Design:  Comparative cross sectional study. Place and Duration of Study:  Department of ophthalmology, Punjab Rangers teaching hospital, Lahore, from July 2019 to December 2019. Methods:  The study included 20 patients each of intermittent exotropia (XT) true and simulated divergence excess exotropia (XT).All the subjects underwent complete orthoptic assessmentthat included AC/A ratio calculation through heterophoria method after monocular occlusion. Results:  The Results showed that patients with true divergence excess exotropia have a high AC/A ratio as compared to patients with simulated divergence excess exotropia who have a normal AC/A ratio. 57% patients showed true divergence excess exotropia with high AC/A ratio while 43% had divergence excess with normal AC/A ratio. Conclusion:  The response of AC/A was found to be higher in patients with true divergence excess exotropia after monocular occlusion. Key Words:  Intermittent exotropia, True simulated divergence excess exotropia, simulated divergence excess exotropia.