Objective To evaluate the short-term outcomes after femtosecond laser-assisted laser in situ keratomileusis （FEMTO-LASIK） in highly astigmatic myopes. Methods Eyes with more than 2.0 diopters （D） of astigmatism were identified from patient records. The mean preoperative cylinder was -2.45±0.62 DC in myopic eyes. Patients were examined preoperatively and 3 months postoperatively. Laser in situ keratomileusis was performed with a WaveLight FS200 femtosecond laser and a WaveLight eye-Qexcimer laser. Preoperative and postoperative refractions were converted to vector values. Induced torsion of the cylinder axis and the correction achieved for sphere and cylinder were determined. Data were analyzed using a paired t test and linear regression. Results After 3 months， the mean sphere was +0.37±0.50 D in myopic eyes and the mean cylinder was -0.57±0.44 D. Spherical equivalent（SE） correction was +0.18±0.48 D from the target value. Astigmatism was undercorrected by -0.30±0.43 D（t=6.17， P<0.01）， and the mean induced torsion of the axis was 0.09±0.34 radians（t=2.22， P<0.05）. Attempted and achieved SE corrections were highly correlated （R2=0.96）. Conclusion Laser in situ keratomileusis in highly astigmatic eyes can precisely correct SE refraction but leads to astigmatic undercorrection. A slight counterclockwise torsion of the cylinder axis was induced.