The incidence of Acanthamoeba keratitis has decreased significantly, and it is no longer a reportable condition in the United States. Corneal abrasion and contact lenses play an important role in the development of Acanthamoeba keratitis. One of the most important features of the disease is severe pain, which is atypical for herpes simplex. The pathognomonic sign for Acanthamoeba is radial neuritis or inflammation around the corneal nerve caused by the parasites. The most important step in prevention of Acanthamoeba keratitis is effective education of patients about the care of contact lenses. A combination of Brolene and Neomycin is the best approach in treating Acanthamoeba keratitis. However, if treatment with these drugs fails, clotrimazole is recommended.