To evaluate the monocular and binocular visual outcomes in myopic astigmatism and presbyopia patients, after laser in situ keratomileusis (LASIK) with a Q value guided non-linear aspheric monovision protocol. METHODS: A retrospective and non-comparative study was performed based upon 80 eyes of 40 consecutive patients with myopic astigmatism and presbyopia, who underwent Q value guided non-linear aspheric monovision LASIK by the Carl Zeiss Meditec CRS-Master software and MEL 80 excimer laser, from August 2006 to March-2009. At the 1 day, 1 week, 1 month, 3, 6 months, 1 year postoperative visits, the examinations were carried out in terms of distance and near, monocular and binocular visual acuity, manifest refraction, topography and keratometry, wavefront assessment, contrast sensitivity, and stereopsis. In addition, questionnaires of asthenopic symptoms due to near-distance work were also implemented for all the patients preoperatively and 6 months postoperatively. RESULTS: Six months postoperatively 92% and 99% of the differences between spherical equivalent(SE) and target SE were in the ranges of 0.50D and 1.00D, respectively. 3 months to 1 year postoperatively, the variation of SE was -0.06±0.37D. 1 month postoperatively, achieved monocular uncorrected distance visual acuity of 20/20 was in 95% of distance eyes, and binocular uncorrected near visual acuity of J2 in 87.5%, and J5 in 100% of patients. 1 week postoperatively, a slight decrease in contrast sensitivity and stereopsis（P＜0.05) was observed in binocular. 1 to 3 months later contrast sensitivity increased, but there was no change in stereopsis 1 month postoperatively. The average change in refraction between 3 months and 1 year was -0.06±031D. Asthenopic symptoms due to near-distance work were improved. CONCLUSION: Q value guided non-linear aspheric monovision LASIK is a valid，well-tolerated, stable, and effective option for myopic patients with presbyopia in moderate to high myopic astigmatism. Good visual outcomes could be obtained with this procedure.