A 60-year-old man with stable bilateral thyroid eye disease (TED) underwent unilateral strabismus surgery. Within 1 month, he developed TED reactivation in only the contralateral orbit. At a later date, again after 6 months of inactive TED, he underwent bilateral strabismus surgery. Within 1 month of surgery, he developed bilateral TED reactivation. Surgical manipulation of orbital tissues may, in rare cases, provoke reactivation of TED.