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Abstract Purpose: To evaluate topographic changes following accelerated pulsed crosslinking in keratoconus patients. Methods: This is a retrospective study in which all patients with keratoconus grade (1-3) according to amsler-krumeich classification presented to Eye Care center, Maadi, Cairo between [2014 - 2017] and underwent epithelium off pulsed light accelerated crosslinking using the KXL system (Avedro Inc., Waltham, MS, USA) 30 mW/cm² for 8 minutes (1 s off, 1 s on) and followed up for 12 months at least. Results: A total number of 72 eyes of 38 patients were included in this study. Out of which, 34 patients (89.0%) were bilateral while 4 patients (11.0%) were unilateral. Included patients were in the mean age of 29.8 with standard deviation (±SD) 6.2, ranging from 18 to 40 years. The patient`s gender ratio was 21 males (55.0%) and 17 females (45.0%). 35 eyes (49.0 %) were right while the remaining 37 eyes (51.0 %) were left. There were some dropped out cases during follow up where 62 eyes (86.1%) of 32 patients completed the 12-month follow up, 13 eyes (18.1%) of seven patients completed 24 months follow up and 15 eyes (20.8%) of eight patients reached 36 months follow up |