Purpose: To analyze real-world graft survival and visual acuity outcomes of corneal transplantation in Europe.Setting: Corneal clinics in 10 European Union member states, the United Kingdom, and Switzerland.Design: Multinational registry study.Methods: All corneal transplant procedures registered in the European Cornea and Cell Transplantation Registry (ECCTR) were identified. Graft survival of primary corneal transplants were analyzed using Kaplan-Meier survival curves with log-rank test and Cox regression. Corrected distance visual acuities (CDVAs) are reported at baseline and 2 years postoperatively using the Lundstro & uml;m distribution matrix.& nbsp;Results: A total of 12913 corneal transplants were identified. Overall, 32-year graft survival of corneal transplants was high (89%) but differed between indications, ranging from 98% in keratoconus and 80% for trauma. Overall, CDVA improved postoperatively, but the risk for losing vision ranged from 7% (baseline vision <= 0.1 Snellen) to 58% (baseline vision >= 1.0 Snellen).Conclusions: This report provides a comprehensive overview of graft survival and visual outcomes of corneal transplantation in Europe. In addition, it provides real-world estimates of outcomes for a variety of indications and surgical techniques to support benchmarking and demonstrates the relationship between baseline and postoperative vision.