Aim: To study the complications and visual impairment in vernal keratoconjunctivitis. Method: A prospective hospital-based study was carried out in 100 VKC patients over a period of 2 years. All patients suffering from VKC irrespective of age and gender were included while patients suffering from ocular infections and ocular trauma were excluded from the study. Ocular complaints, duration of symptoms and previous treatment taken. The ocular examination included visual acuity, slit lamp examination, IOP and refraction. Results: Corneal complications were noted in 21% of cases followed by lids in 18% of cases. Corneal complications such as superficial scarring was noted in 11% followed by micropannus in 4%, pseudogerontoxon in 3% and shield ulcer in 2% and keratoconus in 1%. the corneal involvement was seen in 5.5% in palpebral form, 23.53% in bulbar, and 48.2% in mixed pattern of VKC. Thus, it is concluded that maximum corneal involvement is observed in mixed clinical pattern of VKC. Majority of cases (82%) had visual acuity ranging from 6/6 to 6/9 in right eye as well as left eye. Visual acuity in the form of counting fingers was present in 4 cases. Out of 100 cases, 55% cases showed refractive errors in the form of astigmatism, myopia and hypermetropia. Astigmatism was found to be commonest refractive error. In our study we observed steroid induced glaucoma in 1% of cases. Conclusion: VKC is of more concern due to involvement of cornea and its complications like, shield ulcers, superficial corneal scarring, keratoconus, astigmatism, mechanical ptosis. Steroid induced glaucoma although rare but is a serious complication. Visual acuity is affected mainly due to corneal involvement leading to astigmatism, scarring and keratoconus.