Background: With reports coming from the Asia Pacific region, Pythium keratitis has been the subject of increased interest in recent years.The present study was conducted to assess clinical profile of patients with P. Insidiosum keratitis. Materials & Methods: 84 cases of P. Insidiosum keratitis of both genders were selected. Predisposing factors, clinical course, microbiological results, treatment, visual outcomes, and demographic information were all documented. Results: Out of 84 patients, 50 were males and 34 were females. Visual acuity 6/6-6/60 was seen in 16, 5/60-1/60 in 30 and <1/60 in 38. Clinical presentation was dot like infiltrate in 20, tentacle like infiltrate in 45, peripheral furrowing in 10 and perforated corneal ulcer in 9 cases. The difference was significant (P< 0.05). The risk factors were dirty water in 22, insect injury in 10, dust in 32, and unknown in 20 cases. Previous treatment done was antibacterial in 28, anti- fungal in 8, antifungal- antibacterial in 42 and no treatment in 6 cases. The difference was significant (P< 0.05). Conclusion: Dust, insect injuries, contaminated water, and unknown were common risk factors. Clinical manifestations included peripheral furrows, a perforated corneal ulcer, and dot-like and tentacle-like infiltrates.