AbstractWe developed a novel acoustic radiation force optical coherence elastography (ARF‐OCE) based on an ultrasmall ultrasound transducer for quantitative biomechanics evaluations of in vivo cornea. A custom single‐sided meta‐ultrasonic transducer with an outer diameter of 1.8 mm, focal spot diameter of 1.6 mm, central frequency of 930 kHz, and focal length of 0.8 mm was applied to excite the sample. The sample arm of the ARF‐OCE system employed a three‐dimensional printed holder that allowed for ultrasound excitation and ARF‐OCE detection. The phase‐resolved algorithm was combined with a Lamb wave model to depth‐resolved evaluate corneal biomechanics after keratoconus and cross‐linking treatments (CXL). The results showed that, compare to the healthy cornea, the Lamb wave velocity was significantly reduced in the keratoconus, increased in the cornea after CXL, and increased with cross‐linked irradiation energy in the cornea. These results indicated the good clinical translation potential of the proposed novel ARF‐OCE.