Aim: To evaluate the results of stream light trans photorefractive keratectomy (t- PRK) procedure in the treatment of moderate to high myopic astigmatism. Methods: In this retrospective case series, 30 eyes of 15 patients with age between 18 and 34 years who underwent trans PRK treatment for high astigmatism were enrolled. trans PRK was performed using Alcon WaveLight EX500. Visual and refractive outcomes were assessed at 1, 3 and 6 months after the treatment. Results: The mean preoperative manifest astigmatism was 3.2 ± 0.9D. The mean preoperative spherical equivalent -2.8 ± 1.45D. The mean preoperative BCDVA 0.9 ± 0.08 Decimal. At 6 months post-surgery, the mean postoperative UCDVA 1.06 ± 0.13 Decimal. The mean postoperative spherical equivalent 0.16 ± 0.27D. The mean postoperative residual refractive cylinder was 0.4 ± 0.26 D. Eyes with postoperative residual refractive cylinder of 0.5D or less represented 70% (21 eyes). Eyes with postoperative residual refractive cylinder of 0.75D or less represented 100% (30 eyes). Two eyes (6.6%) have non-significant paracentral corneal haze grade 1 during the follow up time. Conclusion: The study showed that trans (stream light) PRK with MMC is effective, safe and predictable method in the treatment of moderate to high myopic astigmatism.