Objective  To investigate the clinical efficacy， safety， predictability and stability of femtosecond laser small incision lenticule extraction （SMILE） for the treatment of myopia. Methods  In this prospective observational study， 94 patients （170 eyes） with myopia underwent SMILE surgeries. The average age of the patients was 26.8±4.7 years （range 18 to 44 years）. The mean preoperative spherical equivalent （SE） was -6.20±1.37 diopters （D）， from -3.25 to -9.13 D. The median myopic astigmatism was -0.75（0.75） D， up to -3.25 D. The mean corneal thickness was 554.7±27.5 μm （range 484 to 600 μm）. Routine ophthalmic examinations were performed. The patients were followed from 6 months to 2 years with uncorrected visual acuity （UCVA）， best corrected visual acuity （BCVA）， manifest refraction， intraocular pressure， corneal topography， and slit lamp examinations. The results were analyzed with a paired t test and linear regression analysis. Results  All procedures were completed successfully. At the long-term follow-up examination， 97% of eyes had a UCVA of 1.0 or better and 100% of eyes had a UCVA of 0.8 or better. BCVA was equal to or better than the preoperative BCVA in 100% of eyes. 35% gained one line and 10% gained two lines of BCVA. The mean postoperative SE was -0.01±0.45 D and 87% and 100% were within ±0.50 and ±1.00 D of the attempted correction. The root mean square （RMS） values of total higher order aberrations （HOA）， spherical aberrations and coma increased by a significant amount after surgery： 0.15±0.12 μm， 0.04±0.11 μm， 0.14±0.14 μm （t=-6.861， -2.078， -5.672， P<0.05）. Conclusion  The SMILE procedure is safe， effective， predictable and the results were stable for treating myopia. HOA， spherical and coma aberrations increased postoperatively but the change in spherical aberrations was small.