Background: Scheimpflug camera uses various indices such as corneal thickness, detection of early and subclinical cases of keratoconus is challenging for the most refractive surgeon. However, corneal tomographic imaging is of great value in detecting such early changes. Purpose: To assess the pattern of refractive conditions implying corneal astigmatism, and KC, in an Egyptian population attending a major referral diagnostic eye center, ODLU, as assessed by Schleimpflug Imaging. Study Design: A retrospective, non-randomized, single-center, observational study. Patients and Methods: 501 recorded files for patients who were referred to ODLU for corneal tomography assessed by Scheimpflug imaging were retrieved by the serial selection, from January 2014 to June 2016 Results: 501 eyes, of 276 patients were analyzed, 50.7% males and 49.3% females, ranged from 5 to 80 years old, number of normal corneas was 39 eyes (7.8%), astigmatism 0.5D-1.5D was 120 eyes (24%), astigmatism >1.5D: 342 eyes (68.3%). The number of trauma/operated corneas( keratoplasty or LASIK) was 77 eyes(15.4%). The number of eyes with KC was 144 eyes (28.74%), The KC suspect corneas were 32 eyes (6.77%) Conclusion: The largest number of patients who were referred for corneal tomography had astigmatism more than 1.5 D, the number of keratoconus suspects was higher in females in the 20 to 40 years age group, however, the severity of keratoconus was more in males at the same age group.