Corneal endothelial dysfunction occurs when corneal endothelial cells (CECs) are dramatically lost and eventually results in vision loss. Corneal transplantation is the only solution at present. However, corneal transplantation requires a fresh human cornea and there is a worldwide shortage of donors. Therefore, finding new functional CECs to replace human CECs is urgent. Skin-derived precursors (SKPs) can be easily acquired and have multiple differential potential. We co-cultured human SKPs with B4G12 cells in serum-free medium and obtained abundant CEC-like cells which had similar morphology and characteristic to human CECs. CEC-like cells exerted excellent therapeutic effect when they were transplanted into rabbit and monkey corneal endothelial dysfunction models by injection method. This protocol enables efficient production of CEC-like cells from SKPs. The renewable cell source, novel derivation method and simple treatment strategy may lead to potential applications in cell replacement therapy for corneal endothelial dysfunction.Corneal endothelial cells (CECs) are a monolayer of hexagonal cells covering the posterior surface of the cornea, and serve as a barrier between the corneal stroma and the aqueous humor. The tight junction as well as the ionic "pump" functions of CECs are important factors that maintain corneal transparency 1 . Many pathological factors such as trauma, surgery, and inflammation may cause dramatic loss of endothelial cell density, resulting in corneal endothelial dysfunction which is characterized by corneal edema, bullous keratopathy, and loss of visual acuity 2 . Human CECs have limited proliferative capacity in vivo and cannot be subcultured for more than a few passages in vitro 3,4 . Corneal transplantation is the only solution at present. However, corneal transplantation requires a fresh human cornea and there is a worldwide shortage of donors 5 . Therefore, finding new functional CECs to replace human CECs is a new and potential direction for future clinical application.Skin-derived precursors (SKPs) were discovered by Tomas 6,7 , and they have been a research hotspot in recent years. SKPs can be isolated in large quantities from many parts of the skin in rodents and humans. As they are multipotent, they can be differentiated into several functional cell types 8 , and are able to suppress the allogeneic activation of T-lymphocytes resulting in an improved health status of animals suffering from a graft-versus-host reaction 9 . Moreover, SKPs were demonstrated to be embryonic neural-crest-related precursors and share many properties with neural crest stem cells 10