Introduction. Keratoconus is the most common primary ectasia and has a significant effect on visual acuity and the quality of life. The prevalence of keratoconus in the general population of Bosnia & Herzegovina, and Croatia remains unknown. This study was designed to show the incidence of keratoconus in candidates for Excimer laser refractive surgical procedures in our eye clinics. Methods. We analyzed preoperative examination data from 2,714 patients, collected over a two year period, who were candidates for Excimer refractive surgical procedures. Patients were sorted into groups according to their gender, age, degree of keratoconus (Amsler-Krumeich classification) and involvement of one or both eyes. Results. Keratoconus was detected in 231 patients (335 eyes); 133 of the patients were male and 99 were female. Unilateral keratoconus was found in 127, and bilateral in 104 patients. Four age groups were designated: 49 were 18 - 25 years old, 68 patients were 25 - 35 years old, and 57 were in both age groups, 36 - 45 and 45 -75 years. Keratoconus was diagnosed in 335 eyes with the following distribution: stage I - 86, stage II - 84, stage III - 97, and stage IV - 68 eyes. Conclusion. We examined a large number of patients preoperatively and found a higher prevalence of keratoconus than previously reported for the general population. Our particular sample does not accurately reflect the prevalence of the disorder within the general regional population of Bosnia & Herzegovina, and Croatia. Nonetheless, our findings signal a need for public health outreach and intervention for keratoconus within those regions.