Laser in situ keratomileusis (LASIK) is the most common used refractive surgery. The technology advancement in microkeratome design, laser technology and wavefront-guided technology has improved the safety, efficacy and predictability of surgical outcomes. This chapter provides in-depth information on microkeratome, femtosecond lasers, excimer laser and wavefront analysis. The basic components of a microkeratome consist of control console, body or motor, head, blade and suction ring. The mechanical microkeratomes discussed are Hansatome microkeratomes, Zyoptix XP microkeratomes, the Summit Krumeich-Barraquer microkeratome, the Amadeus II microkeratome, MK-2000 microkeratomes, the Carriazo-Barraquer microkeratome, and the Carriazo-Pendular microkeratome. Some common femtosecond lasers used are IntraLase, Technolas 520F, VisuMax femtosecond laser, Femto LDV femtosecond laser and the WaveLight FS200 femtosecond laser. Different excimer lasers discussed are Zytopix technolas platform, LADARVision 4000 excimer laser, EC-5000 excimer laser, WaveLight Allegretto Wave System and SCHWIND AMARIS excimer laser. The commonly used Wavefront-guided lasers are the Zyoptix Technolas, LADAR CustomCorneaTM, VISX CustomVueTM, and the Allegretto Wavelight.