With the development of modern medical technology, the accuracy and safety of refractive surgery in ophthalmology have been constantly improved. Many new examination methods have been applied in research and clinical practice, and anterior segment optical coherence tomography (AS-OCT) is a new non-contact non-invasive optical image diagnosis technology, which can be used to measure the biological structure of anterior segment. AS-OCT is widely used in the clinical diagnosis and treatment of corneal diseases, cataracts, glaucoma and other specialties due to its advantages of fast scanning speed, deep layer, high penetration rate and high resolution. In addition, AS-OCT can also obtain: corneal thickness, corneal epithelial thickness map, corneal topographic map, anterior chamber depth (ACD), white to white (WTW), crystal arch height (LV), Angle width of the anterior chamber, etc., so it is especially suitable for the pre-operative screening, design of operation scheme and safety evaluation after the operation of auxiliary ophthalmic refractive surgery (including corneal refractive surgery and intraocular refractive surgery). At present, corneal refractive surgery mainly includes excimer laser in-situ keratomileusis (LASIK), femtosecond laser-assisted LASIK (FS-LASIK), femtosecond laser stromal lens removal for small incision (SMILE), and transepithelial laser keratoplasty (T-PRK), and ICL implantation is the main method of intraocular refractive surgery. This article will review the clinical application of AS-OCT in corneal refractive surgery and intraocular refractive surgery, and provide reference for clinical practice.