Objective To assess the clinical efficacy of orthokeratology in the treatment of adolescents with moderate myopia； to assess the changes in refraction， corneal thickness and axial length after 1 year of wear. Methods This was a prospective study. Thirty-seven young myopia patients （9-15 years old） were fitted with orthokeratology lenses and refraction， visual acuity， and corneal curvature were measured. Patients wore the ortokeratology lenses for one year and then were required to discontinue wearing the lenses. Fifty patients （9-15 years old） were fitted with spectacles for the same time period. The changes in refraction and axial length were measured one month after the discontinuation of lens wear. Data were analyzed using repeated measured ANOVA and independent t test. Results After 1 year， the spherical equivalent refractions were -4.69±0.57 D in the orthokeratology lens group and -4.72±0.80 D in the spectacle group. Increases in spherical equivalent refraction were 0.31±0.21 D and 0.77±0.46 D， respectively， in the two groups， indicating a statistically significant difference （t=30.109， P＜0.01）. The axial length increases were 0.11±0.26 mm and 0.26±0.60 mm， respectively， in the two groups， indicating a statistically significant difference （t=18.565， P＜0.01）. The corneal thickness in orthokeratology group before and 1 year after lens wear was insignificantly different. Conclusion Orthokeratology treatment for moderate myopia in adolescents can significantly improve visual acuity. The progression of myopia can be controlled to a certain extent. And the increase in axial length can be effectively controlled.