Background: KC is a bilateral, progressive, non-inflammatory corneal degeneration. Corneal deformation and thinning causes irregular astigmatism and leads to visual impairment. Aim of the work: this study aimed to evaluate simultaneous topography-guided partial PRK and CXL as a therapeutic intervention in patients with KC. Methodology: the present study was designed to evaluate simultaneous topography-guided partial PRK and CXL as a therapeutic intervention in patients with KC. It included 25 keratoconic eyes of 17 patients; 8 cases were bilateral and 9 cases were unilateral.  All included cases underwent full history taking and ophthalmologic examinations for preoperative evaluation and postoperative assessment. Follow up was carried out at first postoperative day and at 1, 3 and 6 months post-operatively. Results: when comparing K1, K2, thinnest location and BCVA at 1, 3 and 6 months postoperatively to the corresponding values at first postoperative day, there was non-significant difference at any point of time.  Conclusion:  simultaneous topography-guided partial PRK and CXL as a therapeutic intervention in patients with keratoconus is an effective without significant complications; thus, it had a good efficacy, stability over time and safety.