This project was designed to study the efficacy of orthokeratology and its related problems in a population of young myopic adolescents. Fifty-four young myopia adolescents ages 11 to 15 years were enrolled in the study and followed over a 6-month period. The procedures included (1) baseline refraction, assessment of tear quality and quantity, and cornea examination including cornea topography, A-scan ultrasound of cornea thickness, and spectromicroscopy of the corneal endothelium; (2) diagnostic lens fitting and evaluation; (3) lens dispensing and educating the patients or their parents; (4) follow-up schedule and data analysis; and (5) maintenance lens dispensing and analysis of wearing schedules. Myopia was reduced between -1.25 and -5.00 D (-3.00 D average). Myopia reduction was almost complete in the first 6 months, with most of the reduction occurring during the first 2 weeks. Seventy-five percent of the possible reduction occurred during this 2-week time period. Tear quality and quantity influenced reduction speed and amount. Corneal thickness and endothelium remained unchanged over the study period. Subjective refraction is the most reliable method to measure the status of ocular refractive changes. Corneal staining occurred in 45% of subjects during the procedure, mainly in subjects with tear problems. Eighteen percent of the subjects showed induced astigmatism, which could be reversed by refitting the lens or changing the wearing schedule. Maintenance lenses had to be worn every night for young adolescents to maintain myopia reduction. Orthokeratology is a reliable option for reducing some myopia in young adolescents. The first 2 weeks are critical for the procedure. Complete examination and the data analysis procedures are important for monitoring prognosis and eye health.