AIM: To investigate the early changes of corneal higher-order aberrations(HOAs)of the anterior surface, posterior surface, and total cornea after femtosecond laser-assisted in situ keratomileusis(FS-LASIK)in mild to moderate myopic and high myopic patients. METHODS: This retrospective study included 129 patients(129 eyes)underwent FS-LASIK surgery from December 2018 to December 2019. Treated eyes were divided into two groups, according to the preoperative spherical equivalent(SE): mild to moderate myopic group(<-6.0D, 76 eyes)and high myopic group(≥-6.0D, 53 eyes). Corneal HOAs of the anterior surface, posterior surface, and total cornea were measured by Pentacam anterior segment analysis system preoperatively and 6mo postoperatively. RESULTS: The tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea, significantly increased in both groups 6mo postoperatively(all P<0.01). And more tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea were induced in high myopic group than mild to moderate myopic group postoperatively(all P<0.01). The horizontal coma of the posterior surface, significantly increased in both groups 6mo after operation(all P<0.01). And more horizontal coma of the posterior surface were induced in high myopic group than mild to moderate myopic group postoperatively(P<0.01). Changes in anterior surface and total corneal tHOAs, spherical aberrations and horizontal coma were related to the SE(all P<0.01).CONCLUSION:Anterior and total corneal tHOAs, spherical aberrations and horizontal coma, significantly increased after FS-LASIK, and aberration changes were related to SE. Whereas posterior corneal HOAs remained stable except horizontal coma. The long-term effect should be investigated in the future.