Vernal keratoconjunctivitis (VKC) is an acute – on – chronic inflammatory disease of the conjunctiva and cornea, encountered usually in the very first decade of life in children. Aims and Objectives: To determine the clinical efficacy of 0.03% tacrolimus eye ointment in refractive Vernal Keratoconjunctivitis (VKC) in patients with corneal involvement, based on a study done on children in their first and second decade of life. Materials And Methods: Prospective observational study of 110 patients aged 7- 18yr (I2±5yrs). After taking history, 8 clinical signs and 5 symptoms were noted and graded. Patients were started with 0.03% tacrolimus eye ointment twice daily and followed up for 6 months. Results and Observations: Statistically significant improvement was noted in patients with corneal involvement and giant papillary lesions (p<0.001), 47 patients (43%) showed improvement after 1 month. After 6 months, 105 patients (95%) showed improvement in signs and symptoms. The only side effect observed was burning sensation in 3 patients, which was relieved with lubricating drops (0.5% Carboxy-Methyl-cellulose) given four times a day. Conclusion: 0.03% Tacrolimus eye ointment was safe and effective in VKC cases, resistant to anti-allergic/steroid/cyclosporine eye drops, especially with proliferative lesions and corneal involvement