Introduction: This study sought to determine whether the application of 0.01% atropine eye drops could impact the disparity in refraction and axial length (AL) between the right and left eyes in Chinese children.Methods: The study was designed as a double-blind, placebo-controlled randomized trial. A total of 220 children aged 6-12 years were recruited from the Beijing Tongren Hospital in Beijing, China. Participants were randomized in a 1:1 ratio and were prescribed 0.01% atropine or placebo eye drops to be administered once a night to both eyes for the duration of one year. The cycloplegic refraction and AL was recorded including baseline, 6 months, and again at the twelve months.Results: After one-year follow-up period, 76 (69%) and 83 (75%) subjects of the initial 220 participants were identified as the 0.01% atropine and placebo groups, respectively. The inter-ocular difference in spherical equivalent refraction (SER) and AL demonstrated stable values in the 0.01% atropine treatment group (SER: p=0.590; AL: p=0.322) analyzed after one-year, but found a significant increase (SER: p<0.001; AL: p=0.001) in the placebo group. Furthermore, over one year, eyes with greater myopia in the atropine group exhibited slower myopia progression (0.45 +/- 0.44D) than the lesser myopic eye (0.56 +/- 0.44D) (p=0.003).Conclusion: This study demonstrated that 0.01% atropine could maintain the inter-ocular SER and AL difference. And 0.01% atropine appeared to be more effective in delaying the progression of myopia in eyes with more myopia than in the less myopic eyes.