Abstract: Objective To report the evolving of the indications for keratoplasty and the shift of the type of keratoplasty performed in Chinese PLA General Hospital from 2004 to 2015. Methods A retrospective data review was carried out to all the records of keratoplasty in Chinese PLA General Hospital from January 2004 to December 2015, and patient's demographics, indications and types of transplantation performed were analyzed. Results Totally 721 keratoplasties were performed on 631 patients. Four hundred and thirty patients (68.15%) were male (489 eyes), and 201 cases(31.85%) were female(232 eyes). Keratoleukoma (135 cases, 18.72%), regraft (122 cases, 16.92%), purulent keratitis (90 cases, 12.48%) and keratoconus (89 cases, 12.34%) were the leading indications for keratoplasty, and transplantations for purulent keratitis, regraft and keratoconus increased year by year. In 2004, keratoplasties were performed in 3 cases of purulent keratitis, 9 cases of regraft and 3 cases of keratoconus, and the frequencies reached to 16, 15 and 20 respectively in 2015. Of all keratoplasties performed, 414 (57.42%) were penetrating keratoplasty (PKP), 161(22.33%) were deep lamellar keratoplasty (DLKP), 134(18.59%) were lamellar keratoplasty(LKP), and 12(1.66%) were endothelia keratoplasty (EKP). DLKP (2010, n=6; 2015, n=20) and LKP (2010, n=8; 2015, n=18) increased in recent 5 years, while PKP had been decreasing since 2012(2012, n=60; 2015, n=34). Conclusion The keratoleukoma, regraft, purulent keratitis and keratoconus were the top 4 indications for keratoplasty. DLKP demonstrated an increasing trend while PKP showed a decrease. EKP has been applied in clinical practice.