Background: Vernal keratoconjunctivitis (VKC) is a chronic hypersensitive condition of the eye that affect conjunctiva and cornea. The symptoms of vernal keratoconjunctivitis can vary but typically include itching, hyperemia, photophobia and foreign body sensation. This study concentrates on the effect of tacrolimus 0.03% ointment in treatment of VKC in children. Objective: This study aimed to assess the efficacy as well as safety of using tacrolimus 0.03% ointment in treatment of VKC in children. Subjects and methods: We conducted this prospective case study on a random group of 30 patients (60 eyes) of pediatric age group with vernal keratoconjunctivitis using tacrolimus topical preparation. Results: The mean age was 13 ± 3 years. The mean visual acuity improved from 0.8 ± 0.2 to 0.9 ± 0.1 after the treatment. Statistically significant improvement was found in symptoms of redness, foreign body sensation, itching, as well as tearing. Statistically significant improvement was also revealed among the clinical signs of conjunctival hyperemia, Tranta's dots, limbal infiltration, superficial punctate keratitis, as well as conjunctival papillary hypertrophy. No side effects were recorded as cataract, or infectious keratitis. Mild and moderate relapse of symptoms and signs were seen in 8 patients (26.7%) after 6 months during their follow up and all of them were considered to be severe at the beginning of the study. Conclusion: Tacrolimus 0.03% ointment could be an effective safe treatment option for VKC in children and could be a steroid sparing agent.