Binocular diplopia occurs from misalignment of the eyes. The fixation object is imaged onto the fovea of one eye and a nonfoveal region of the misaligned eye, creating diplopia. Treatment options include ocular occlusion, monovision optical correction, prism glasses, strabismus surgery, and chemodenervation. Ocular occlusion and monovision optical correction enable the patient to ignore the image from the misaligned eye. Prism glasses alter the light pathways so that the fixation object is imaged onto the fovea of both eyes, despite ocular misalignment. Strabismus surgery and chemodenervation attempt to restore ocular alignment. This article reviews the mechanisms and indications for each of these treatment options for patients with diplopia.