AIM: To evaluate the relationship of isoametropic amblyopia with the prevalence of hyperopia in young children with hyperopia and orthotropia. METHODS: Fifty-six children with a mean age of 5.5 years and bilateral symmetric hyperopia were selected and assigned to the following two groups, children with bilateral hyperopia ≤+4.0D spherical equivalent (Sph. Eq.) and those with bilateral hyperopia ＞+4.0D Sph. Eq.. Prevalence of isoametropic amblyopia was estimated and compared between the two groups. RESULTS: Among the 32 children with bilateral hyperopia of ≤+4.0D Sph.Eq.,4 children(13%) had isoametropic amblyopia, while among the 24 children with bilateral hyperopia of ＞+4.0D Sph. Eq., 15 children(63%) had isoametropic amblyopia. Statistical analysis revealed a significant difference for prevalence of amblyopia between the two groups of isoametropic children (P＜0.05). CONCLUSION: Isoametropic amblyopia is not rare among children with bilateral hyperopia, especially when hyperopia is more than +4.0D Sph. Eq. On the bases of this investigation, children with bilateral hyperopia ＞+4.0D have a risk of 13%-63% developing isoametropic amblyopia. Thus, indicating that children with hyperopia of ＞+4.0D have an increased risk of isoametropic amblyopia.