Objective To analyze the existence of astigmatism with accommodation and its possible effect on near vision work.Methods It was a cross-sectional study.The refraction of 166 astigmatic eyes of 87 patients were measured at distance (at 5 m) and near (at 40 cm).The distance corrected near visual acuity (DCNVA) and accommodative astigmatism corrected near visual acuity (ACNVA) were measured with distance-corrected glasses and neas-corrected glasses,respectively,using near vision chart.The astigmatism at near was measured under monocular condition with crosscylinder lenses.The degree of astigmatism at far and near,the axis of astigmatism at far and near,DCNVA and ACNVA were compared by paired t test respectively if the data were normal distribution,if not,compared by Wilcoxon matched-pairs signed-ranks test.Analyzed the association between the astigmatism changes and residual astigmatism.Results The degree of astigmatism with accommodation and the near visual acuity when accommodative astigmatism corrected were both increased significantly (Z=-5.32,P＜0.01 ; Z=-5.74,P＜0.01),similar resulta were obtained in subjects had with-the-rule and oblique astigmatism and astigmatism ≤-1.00 D.But the axis showed no statistical significance.The astigmatism changes showed no significant association with residual astigmatism.Conclusion A change in astigmatism with accommodation does indeed exist,and sometimes affects near vision,especially for tbose who had with-the-rule and oblique astigmatism and astigmatism ≤-1.00 D.So optometrists should pay attention to the examination of near astignatism,especially for those who have near vision problems.