PURPOSE To evaluate the alteration in anterior chamber parameters with the progression of keratoconus using a rotating Scheimpflug camera. SETTING Inonu University, Turgut Ozal Medical Center, Ophthalmology Department, Malatya, Turkey. METHODS Two hundred sixteen eyes of 123 patients diagnosed with keratoconus and 224 eyes of 112 normal subjects were evaluated with a Pentacam Scheimpflug camera (Oculus Inc.). Keratoconic eyes were divided into 3 groups according to mean keratometer (K) readings: mild (K = less than 47.0 diopters [D]), moderate (K = 47.0 to 52.0 D), and severe (K = 52.0 D or higher). The following parameters were obtained: thinnest corneal thickness (TCT), anterior chamber depth (ACD), corneal volume (CV), anterior chamber angle (ACA), and anterior chamber volume (ACV). RESULTS One hundred twenty-nine eyes had mild keratoconus, 59 had moderate keratoconus, and 35 had severe keratoconus. There were no statistically significant differences between the keratoconus group and control group in age, sex, or eye distribution (P>.05). With the progression of the disease, TCT and ACD were statistically different between all groups (P<.05). There were statistically significant differences in ACA and CV measurements between the mild keratoconus and severe keratoconus groups (P<.05). Also, CV readings were significantly different between the control group and all keratoconus groups (P<.05), although there was no significant difference in ACA measurements (P>.05). Despite a progressive increase in the ACV with disease progression, the differences between groups were not statistically significant (P>.05) except between the severe keratoconus group and the control group (P<.05). CONCLUSION Anterior segment parameters of the eye showed significant alterations with the progression of keratoconus.