AIM: To analyze the early diagnosis of 70 cases of fungal keratitis and evaluate the application value of confocal laser corneal microscopy. METHODS: Confocal laser corneal microscopy, corneal tissue smears and fungal cultivation were performed on 70 patients of suspected fungal keratitis.The results were compared . RESULTS: Seventy patients were clinically diagnosed of fungal keratitis based on history, clinical signs. The positive rate of confocal laser corneal microscopy was 94% (66/70).The positive rate of corneal tissue smears was 31% (22/70).The positive rate of fungus cultivation was 20% (14/70). The positive rate of fungal keratitis detected by confocal laser corneal microscopy was higher than by corneal tissue smears (χ2=29.615,P<0.01) and fungal cultivation (χ2=39.433,P<0.01). CONCLUSION: Confocal laser corneal microscopy can be a non-invasive, rapid and effective imaging technique, and it is helpful in the early diagnosis ,treatment and study of fungal keratitis.