Objective To study the effects of femtosecond laser flap making SBK（FS⁃SBK），small inci⁃ sion femtosecond laser stromal lens extraction（SMILE），excimer laser in situ keratomileusis（LASIK）on corneal biomechanics and central corneal endothelial cells in myopic and astigmatic patients. Methods From January 2019 to June 2019，150 cases of myopic astigmatism were selected and divided into FS⁃SBK group，SMILE group and LASIK group through stratified sampling method. FS⁃SBK group was treated with FS⁃SBK，SMILE group was treated with SMILE，LASIK group was treated with LASIK. The corneal biomechanical index，central corneal endothelial cell index（ECD，CV，6a），corneal aberration，vision and diopterand complications were evaluated. Results These indicators were lower in SMILE group than in FS⁃SBK group and LASIK group，including corneal biomechanical index，central corneal endothelial cell index levels（ECD，CV，6a），corneal aberration，diopter andcomplication rate. But the visual acuity was higher in SMILE group than in FS ⁃ SBK group and LASIK group （P < 0.05）. There were no significant differences between FS⁃SBK group and LASIK group in corneal biomechani⁃ cal index，central corneal endothelial cell index levels（ECD，CV，6a），corneal aberration，vision，diopter and complication rate（P > 0.05）. Conclusion Compared with FS⁃SBK and LASIK，SMILE can significantly improve the corneal biomechanical index，central corneal endothelial cell index levels（ECD，CV，6a），corneal aberra⁃ tion，diopter，complication rate，and promote visual recovery.