Endothelial keratoplasty is usually contraindicated in end-stage forms of bullous keratopathy with extensive anterior stromal scarring, as a good visual result is not expected. We describe the use of superficial keratectomy as an initial surgical stage in performing successful endothelial keratoplasty in severe bullous keratopathy with anterior stromal scarring in a patient with previous failed penetrating keratoplasty, which resulted in a good visual outcome.