<h3>ABSTRACT</h3> <h3>Background</h3> To assess the pediatric anterior segment characteristics in ocular pathology, using spectral domain optical coherence tomography (SD-OCT). <h3>Methods</h3> Our case series follows 115 eyes of 78 children aged 2–17 years of age with anterior segment pathology in an academic facility. A thorough eye examination and investigations were performed for each child. The anterior segment optical coherence tomography (AS-OCT) analysis was done using the Optopol Revo 80<sup>®</sup> high resolution SD-OCT (840 nm, axial resolution of 5 µm) using an imaging adapter. All pathological features visible on imaging were observed, studied, tabulated, and analyzed. <h3>Results</h3> 115 eyes of 78 children with anterior segment pathology were imaged. The average age was 11.84 years, with 44 males and 34 females. The primary clinical diagnosis was <i>cataract</i> (congenital and acquired) in 40 (34.8%) eyes, followed by <i>corneal disease</i> (congenital, inflammatory, and traumatic) in 28 (24.3%) eyes, <i>glaucoma</i> (juvenile and secondary) in 18 (15.7%) and <i>trauma</i> in 15 (13%) eyes. Systemic diseases were associated in 20.9%. The commonest imaging pathology observed was <i>lens opacification</i> (any morphology/location) in 43 (37.4%), <i>increased reflectivity of the cornea</i> in 31 (28.2<i>%), corneal stromal thinning</i> in 34 (29.6%), increased corneal thickness in 28 (24.3%), <i>shallow anterior chamber</i> in 17 (14.8%), and <i>cells in anterior chamber</i> in18 (15.7%) eyes, along with a multitude of other findings. <h3>Conclusions</h3> Our study demonstrates that anterior segment optical coherence tomography is a useful non-contact technique used without sedation for the detailed anatomic and pathologic assessment, imaging, diagnosis, and monitoring of pediatric ocular diseases.