Corneal diseases are one of the major causes of blindness and visual impairment in developing countries. Penetrating keratoplasty is a surgical procedure where a damaged or diseased cornea is replaced by donor corneal tissue. Aim was to determine the indications of penetrating keratoplasty (PK) in a tertiary health care centre of North India.Methods: A retrospective analysis of the records of 288 patients, who underwent penetrating keratoplasty (PK) from January 2016 to December 2018 at

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... Institute of Ophthalmology, PGIMS Rohtak were included in this study. All patients who underwent PK during this time period were included in our study except those who underwent regrafting.Results: A total of 288 patients who underwent penetrating keratoplasty (PK) surgery were included in our study. Out of 288, 184 (63.88%) were males and 104 (36.11%) were females. In our study, 162 (56.25%) patients underwent optical PK, 76 (26.38%) had tectonic PK and 50 (17.36%) underwent therapeutic PK. Most common indication for optical PK was bullous keratopathy followed by corneal opacity. Most common reason for tectonic PK was found to be corneal perforation while for therapeutic PK was sloughing corneal ulcer followed by recalcitrant fungal keratitis.Conclusions: Though bullous keratopathy (BK) was the most common indication for penetrating keratoplasty in North India, but in our study 27% patients had tectonic PK and 17% patients underwent therapeutic PK which is significantly higher than documented data from South India and developed countries. It can be because of low literacy level, lack of awareness and late presentation to ophthalmologist in North India.