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AIM: To observe the clinical effect of femtosecond laser assisted penetrating keratoplasty. <p>METHODS: Twenty-four cases(24 eyes)with corneal lesions were performed with femtosecond laser assisted penetrating keratoplasty. Preoperative and postoperative endothelial cell density and visual quality were compared.<p>RESULTS: One week after operation, corneal grafts were clear in 21 eyes(87.5%), mild cloudy in 3 eyes(12.5%); visual acuity ≥0.5 in 18 eyes(75.0%), 0.2～0.4 in 6 eyes(25.0%). After 3mo the mean corneal astigmatism was 2.16±0.21D(range 2.25～3.09D). Compared to conventional penetrating keratoplasty which mean corneal astigmatism was average 3.67±0.38D after operation, there was significant difference between two groups(<i>P</i><0.05). There were significant differences between preoperative and postoperative visual acuity and astigmatism(both <i>P</i><0.05).<p>CONCLUSION: Femtosecond laser assisted penetrating corneal transplantation operation can improve patient's visual quality. And compared to traditional penetrating keratoplasty astigmatism decreased significantly, incision can be made in individual shape more precisely and neatly.