This study aimed to evaluate the reasons for performing penetrating keratoplasty at Nishtar Hospital Multan. The research was conducted by Nishtar Medical University and Hospital in Multan, Pakistan, from December 15, 2022, to June 15, 2023. The study included one hundred patients who presented to the OPD with indications of penetrating keratoplasty. Data was analyzed using SPSS V26 software. The study found that the most common provisional diagnosis among the participants was keratoconus, affecting 25% of them. Keratoconus is a degenerative eye disease that weakens and swells the cornea into a cone shape impairs vision. Post-infective keratitis-induced corneal scar was the second most common indication for penetrating keratoplasty. In conclusion, the study reports on the indications of penetrating keratoplasty at Nishtar Hospital Multan. It found that keratoconus followed by corneal scar (post-infective keratitis) were the leading reasons for performing penetrating keratoplasty.