Corneal infection by Herpes Simplex Virus (HSV) and its recurrences may induce loss of transparency and regularity of shape causing loss of vision. Virus replication at the corneal epithelium and immunologic response to virus antigens retained within the stroma are responsible for the inflammatory process that leads to corneal destruction with cicatricial response and leucoma formation. Early appropriate treatment with topical and systemic antivirals together with topical steroids is key to successful management to achieve rapid resolution of inflammation and to avoid recurrences. In this chapter clinical forms of HSV keratitis are discussed in regard to the pathogenesis and their clinical appearance. Management both medical and surgical is discussed in relation to the various forms of keratitis and their sequalea.