AIM:To study the effectiveness and safety of toric implantable collamer lens (TICL) for high myopic astigmatism. METHODS:TICL were implanted in 20 cases (32 eyes) with high myopic astigmatism. The range of preoperative myopia was -2.00 to -24.00D, mean -11.33±4.93D. Astigmatism range was -1.25 to 6.00D, mean -2.13±126D. All eyes were followed up for 3-12 months. Each eye that received TICL implantation did Pentacam examination and observation on intraocular pressure(IOP), the rotation of TICL et al . RESULTS:The mean absolute rotation 12 months postoperatively was 5.47±3.37 degrees,75.0% of eyes rotated less than 5 degrees. 5 eyes had increased IOP shortly after surgery. Dazzling sensation occurred in 2 cases (3 eyes). No severe complications including cataract or glaucoma occurred. CONCLUSION:The short term clinical outcome of TICL for high myopic astigmatism is effective and reliable and no complications occurred during the observation period. The long term clinical outcome needs to observe.