This study was designed to evaluate the technique of Deep Lamellar Endothelial Keratoplasty and its effect on visual outcome in patients with endothelial failure. Design: prospective, non-comparative, non-randomized case series. Setting:Cairo University hospitals (Kasr El-Aini; Ophthalmic surgical unit). Patients and Methods: DLEK surgery was performed in ten eyes of ten patients with pseudophakic Bullous Keratopathy. 3 cases were complicated, thus evaluation was done for 7 cases. A 9.0 mm scleral partial thickness incision was done to provide access to a deep lamellar corneal pocket. A 7.0 – 7.5 mm posterior lamellar disc was excised and replaced by a donor disc of healthy endothelium. The main outcome measures include: Corneal clarity, Best corrected visual acuity, manifest refractive (MR) astigmatism, corneal Topography data: (Topographic Astigmatism, Average corneal power, SRI, SAI), ultrasonic pachymetry and endothelial cell count (ECC). This was done preoperatively, at 1 month, 3 months, and 6 months postoperatively.Results: At 6 months after surgery, all seven corneas were clear. BCVA varied between 6/12 and 6/36. Average change in MR Astigmatism was 0.58 +/- 0.16 D. Average change in Topographic Astigmatism 0.09 +/- 0.52 D . Average change in corneal power 0.30 +/- 1.36 D. Average SRI was 1.40 +/- 0.27. Average SAI was 1.05 +/- 0.14. The average pachymetry was 550.43 +/- 43.52 μ. ECC was 1907 +/- 487 cells/mm2. Conclusions: DLEK procedure is safe and effective for corneal Endothelial failure. Being a sutureless technique, it provides rapid visual rehabilitation, stable corneal surface topography, and healthy endothelial cells. However, we still need further studies on larger groups for longer follow up to support the conclusions.