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The management of peripheral corneal diseases, including Mooren's ulcer, Terrien's marginal degeneration, peripheral ulcerative keratitis and pellucid marginal degeneration is challenging. Circular grafts must either be very large, resulting in the excision of healthy tissue, or eccentric, leading to high levels of astigmatism. This review summarizes the range of noncircular keratoplasty procedures available to surgeons, in addition to their indications, and surgical techniques.Noncircular grafts have been demonstrated to be useful in the management of peripheral corneal diseases. They are effective at providing tectonic support and also facilitate visual rehabilitation. Specifically, they produce favourable postoperative visual and astigmatic outcomes. The evidence relating to these procedures is largely limited to case reports and case series, with no large-scale studies available.Noncircular keratoplasty procedures are useful in the management of peripheral corneal diseases, which is typically difficult. There is a need for larger studies to investigate the relative advantages and disadvantages of these procedures and further characterize their outcomes.