Astigmatism can be divided into corneal astigmatism and intraocular astigmatism based on their sources.Corneal astigmatism accounts for 70%of the total refractive power of the eye,and the cornea is the main source of human astigmatism.The sources of corneal astigmatism can be divided into congenital astigmatism and acquired astigmatism.Congenital astigmatism can be caused by certain trace element defi-ciencies,while acquired astigmatism can be caused by ocular surface factors,orbital factors,surgical fac-tors,and other related factors.Acquired astigmatism can be reduced through surgery or changing the original surgical method.Understanding of the sources of corneal astigmatism aims to provide clinical evidence for the development of new surgical methods to reduce surgical astigmatism in the future,and to provide clinical ide-as for avoiding acquired astigmatism in the early stages without affecting vision.(Int Rev Ophthalmol,2024,48:224-228)