Abstract Background: Keratoconus is a progressive, bilateral, and asymmetric non-inflammatory corneal ectasia. Corneal Col-lagen Cross-Linking (CXL) is the only treatment option that focused on disease pathology and increasing the biomechanical rigidity of the cornea. HOAs are part of the refractive errors which deteriorate the quality of the retinal image and they are not correctable with sphere and cylinder corrections. Since HOAs can impact visual performance and contrast sensitivity; they are considered important indices in the field of quality of vision. Aim of Study: To determine changes in ocular higher order aberrations (HOAs) after Corneal Collagen Cross Linking (CXL) for Keratoconus (KC). Patients and Methods: This study was conducted between April 2018 and March 2019 comprising 30 keratoconic eyes of 19 patients. Patients were treated with epithelium-off CXL and evaluated at the baseline, 3 and 6 months after the proce-dure. The ocular HOAs were measured and analyzed using Zywave II Aberrometer. Results: There was statistically significant improvement in Best Spectacle-Corrected Visual Acuity between the pre-operative and 6-month evaluations (p < 0.05). HOAs at 6mm were statistically significantly reduced at 6 months. Conclusion: CXL is effective in improving HOA param-eters in eyes with KC. changes in HOAs at 6mm were signif-icantly and strongly associated with the post-operative changes in BSCVA.