Endothelial keratoplasty (EK) is a new surgical method in treatment of corneal endothelial keratopathy, which retains healthy portions of a patient's cornea while replacing diseased endothelium with healthy donor tissue. In the past decade EK has been used increasingly and has shown better results over standard penetrating keratoplasty. The emergence and improvement of EK demonstrate the convert of corneal transplantation to refined and refractive surgery. EK, which has favorable refractive outcomes and potential low rejection rate, opens a new era for the treatment of endothelial dysfunction. However, there are still some aspects requiring to be studied, such as the methods of implantation to decrease graft dislocation rate and endothelial cell loss, use of femtosecond laser in EK to improve refractive errors, and the long-term result of immune rejection rate.