BackgroundTo investigate the knowledge, attitudes, and practices (KAP) of individuals who underwent small incision lenticule extraction (SMILE) surgery and explore the influencing factors.MethodsThis cross-sectional study was conducted from June 21, 2023, to August 13, 2023, at Xiangyang Central Hospital. The participants were patients who had undergone SMILE surgery. The self-designed questionnaire had a Cronbach’s α = 0.849. Multivariable analyses were performed to determine the factors influencing the KAP scores.ResultsFinally, 485 valid questionnaires were analyzed. The median knowledge score was 14 (/17, 82.4%; IQR: 12–15). The median attitude score was 15 (/20, 75.0%; IQR: 14–16). The median practice score was 48 (/60, 80.0%; IQR: 42–54). The knowledge scores correlated to the attitude (r = 0.323, P < 0.001) and practice (r = 0.202, P < 0.001) scores, while the attitude scores correlated to the practice scores (r = 0.065, P < 0.001). College diploma (OR = 0.299, 95%CI: 0.110–0.812, P = 0.018), myopia for < 2 years (OR = 0.177, 95%CI: 0.060–0.526), and not receiving proper eye training (OR = 0.588, 95%CI: 0.402–0.862) were independently associated with knowledge. Being 19–30 years old (OR = 0.421, 95%CI: 0.235–0.756), being ≥ 31 years old (OR = 0.259, 95%CI: 0.111–0.601), myopia for 2–5 years (OR = 0.476, 95%CI: 0.232–0.978), myopia for 5–10 years (OR = 0.480, 95%CI: 0.263–0.875), and moderate myopia in the right eye (OR = 1.745, 95%CI: 1.024–2.974) were independently associated with attitude. Female gender (OR = 1.826, 95%CI: 1.196–2.787), being ≥ 31 years (OR = 2.587, 95%CI: 1.113–6.014), college diploma (OR = 3.436, 95%CI: 1.366–8.641), bachelor’s degree (OR = 2.826, 95%CI: 1.214–6.581), and not having proper eye training (OR = 0.458, 95%CI: 0.310–0.677) were independently associated with practice.ConclusionsPatients who underwent SMILE had high KAP regarding SMILE. This study identified KAP items that would warrant education.