Patients undergoing neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy for posterior capsular opacification after penetrating keratoplasty were reviewed retrospectively for incidence of graft rejection. All patients underwent extracapsular cataract extraction with posterior chamber intraocular lens implantation (PC-IOL) performed as a separate or combined procedure. Only one of 20 eyes (4.7%) of 20 patients developed corneal graft rejection over a follow-up period of 6 months to 6 years after capsulotomy. Nd:YAG laser capsulotomy does not appear to increase the risk of corneal graft rejection.