The effectiveness of excimer laser photorefractive keratectomy (PRK) for astigmatism was evaluated. We treated 136 eyes of naturally occurring myopic astigmatism using the 193-nm excimer laser with an expanding slit and an iris diaphragm, and followed for a minimum of 6 months. At 6 months after operation, the mean refractive cylinder decreased from 1.62 ± 0.88 D preoperatively to 0.48 ± 0.48 D. For detailed analysis of the results, the surgically induced refractive change (SIRC) was determined from the preoperative and postoperative refractions by vector analysis of astigmatism. When we compared the cylinder of the SIRC with the preoperative refractive cylinder, the effect of the cylindrical ablation was 93.9 ± 36.7% at 6 months. The axial error of the cylinder of the SIRC to the preoperative cylindrical axis was 5.9 ± 10.2 degrees at 6 months. These results suggest that excimer laser PRK with an expanding slit appears to have a significant effect for the correction of astigmatism.