Suture materials have an important bearing on anatomical and functional success of penetrating keratoplasty. A judicious choice of sutures, suture placement techniques and suture adjustment can go a long way in reducing postoperative astigmatism. Braided silk sutures were commonly used in penetrating keratoplasty before the advent of monofilament synthetic material. The braided silk sutures had the advantage of greater tensile strength, extensibility, knot control, pliability and resistance to shearability. The composition of the needle should provide enough strength to withstand mechanical force but should yield enough not to get fractured. All keratoplasty needles are spatulated reverse cutting with a smaller less traumatic point. The different needles used in keratoplasty are: (a) Full curve needles, (b) Mini curve needles, (c) Bicurve needles, (d) Compound curve needles.