Corneal collagen cross-linking seems to be effective in decreasing progression of KC, with improvements in optical measures in many patients. Postoperative parameters discussed within this review followed a seemingly reproducible trend in their natural course over 12 months. Generally, the trend observed was immediate worsening between baseline and 1 month, resolution at approximately 3 months, and improvement thereafter. In predicting outcomes after CXL, no patient characteristics showed correlations with negative treatment outcomes such as loss of vision or continual topographic steepening. However, steeper KMax (≥55 D) and poorer BCVA (≤20/40) at the time of treatment correlated with better postoperative KMax and BCVA outcomes at 1 year, respectively. These outcome predictors should be considered when offering CXL to patients with KC or postoperative corneal ectasia.