AIM:To investigate the application of confocal microscopy in fungal keratitis.METHODS:A total of 42 patients 42 eyes diagnosed with suspected fungal keratitis were performed the confocal microscopy and corneal lesions stained tissue smear examination simultaneously and the results were analysed retrospectively.RESULTS:In 42 patients 42 eyes with fungal keratitis,fungal hyphae was observed in 39 eyes(93%) by the confocal microscopy,however in 30 eyes(71%) by corneal lesions stained tissue smear examination.Statistical analysis showed that the difference was statistically significant(χ 2=6.574,P<0.05).CONCLUSION:Confocal microscopy is a noninvasive,efficient,intuitive inspection equipment,which has important clinical value in the initial diagnosis of fungal keratitis.