Purpose To demonstrate the utility of anterior segment optical coherence tomography (AS-OCT) in identification of epithelial hyperplasia in a patient with myopic regression after photorefractive keratectomy (PRK). Case Presentation A 26-year-old woman with myopic regression after PRK for high myopia was noted to have a central epithelial hyperplasia with the aid of AS-OCT (Avanti OCT Optovue, Fremont, CA). Conclusion Epithelial hyperplasia can be demonstrated with the aid of AS-OCT and may correlate with myopic regression after PRK. The use of AS-OCT is not only important to elucidate the etiology of myopic regression but also to prepare accurately a retreatment strategy.