PURPOSE To study the efficacy of rigid gas-permeable contact lens (RGPCL) fitting in keratoconus patients and to determine treatment costs. METHODS The records of 126 patients treated at the Hospital das Clínicas de Ribeirão Preto from January 2001 to June 2002 were retrospectively studied. Information about sex, age and treated eyes was collected. Visual acuity (VA) with and without correction was measured and plotted against corneal base curve (K) and toricity. Average price of the lenses was calculated. RESULTS Fitting rigid gas-permeable contact lens was successful in 86.18% of the patients, resulting in VA=0.8 in 40.00% of them. Visual acuity improvement was observed in patients with steep base curve and in patients with high corneal toricity. Age of most patients ranged from 15 to 45 years; 60.31% of them were female. Corneal transplantation was indicated in 11.24% of the cases. Cost of each lens averaged R$ 40.00 (USD 13.00). CONCLUSION Rigid gas-permeable contact lens proved to be an efficient, low-cost resource for improving visual acuity in most of the treated patients.