Objective To evaluate the clinical efficacy of rigid gas-permeable contact lenses （RGPCLs） in the treatment of keratoconus and irregular astigmatism after corneal surgery. Methods This was a prospective study. Twenty-nine patients （38 eyes） were fitted with RGPCLs. The patients included 12 with secondary keratoconus after LASIK （14 eyes） and 1 after LASEK （1 eye）， 8 with irregular astigmatism after corneal transplants （13 eyes）， 2 after ridial keratotomy surgery （4 eyes） and 6 after LASIK surgery （6 eyes）. A paired t-test was used to compare best corrected visual acuity （BCVA） with spectacles and RGPCLs. Patients filled out a subjective assessment questionnaire for evaluating RGPCLs for comfort and ease of cleaning. Results BCVA was ≤4.2 （5 eyes， 13%）， 4.3~4.4 （5 eyes， 13%）， 4.5~4.6 （8 eyes， 21%）， 4.7~4.8 （10 eyes， 26%）， 4.9~5.0 （10 eyes， 26%） and 0 eye （0%） was >5.0 with spectacles. BCVA with RGPCLs was 0 eye （0%）， 0 eye （0%）， 0 eye （0%）， 3 eyes （8%）， 15 eyes （39%） and 20 eyes （53%）. The average BCVA was better with RGPCLs than with spectacles （t=-4.416， P＜0.01）. No serious complications occurred during the follow-up period. Patients reported wearing the lenses feeling comfortable （48%）， easy to wear and pick out lenses （69%） and easy to clean （59%）. Conclusion The RGPCL was significantly more effective than spectacles for secondary kerotoconus and irregular astigmatism after corneal surgery. And RGPCLs were safe to wear.