Purpose.To determine overall 2-and 5-year corneal graft survival rates and to identify risk factors for corneal graft failure in our patient population.Methods.A retrospective chart review of 696 patients undergoing corneal transplantation performed by a single surgeon at The Toronto Western Hospital over a 7.5-year period.Results.A total of 468 eyes met the inclusion criteria for this study. Overall, the 2-and 5-year graft survival rates were 78.8% and 64.5%, respectively. In a univariate analysis, patient age, gender, history of glaucoma, preoperative diagnosis, type of operative procedure, and postoperative factors all were shown to be significantly associated with graft survival. In a multivariate analysis, six independent predictors of graft failure were identified: preoperative diagnosis, neovascularization of the graft, the presence of peripheral anterior synechiae, gender, occurrence of one or more rejection episodes, and age of the recipient at the time of corneal transplantation.Conclusions.Risk of graft failure can vary substantially within a population of patients receiving a corneal transplant. The outcomes of this study concur with the risk factors for corneal graft failure in the literature and can be used as prognostic guidelines for both surgeons and patients.