Introduction: The objective of this study is to compare the outcomes of femtosecond laser assisted DALK with stromal dissection and femtosecond laser-assisted DALK without stromal dissection in the management of keratoconus. Materials and Methodology: A total of 24 keratoconus affected eyes of 20 patients who had undergone femtosecond laser-assisted keratoplasty in the Department. Predescemetric group comprised of 13 eyes from 9 patients (8 males, 2 females) with the mean age of 29.6±8.9 years whereas in the descemetric group 11 eyes from 11 patients (8 males, 3 females). All those treated patients were clearly examined pre and postoperatively with respect to uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: The differences of BCVA, corneal astigmatism, corneal curvature between the two groups were not statistically significant (p>0.05). Loss of endothelial cell density (ECD) was slightly higher in the descemetric group (6.6%) than the predescemetric group (4.8%). But the mean postoperative myopia was -9.45±7.47 D in the predescemetric group when compared with -1.05±1.15D in descemetric group which was seemed to be statistically significant. Conclusion: Femtosecond laser-assisted descemetric lamellar keratoplasty with big bubble technique has proved to be the alternative procedure to manage the patients with keratoconus when compared with femtosecond laser-assisted predescemetric lamellar keratoplasty.