Purpose This study intends to compare the characteristic distributive epithelial pattern by Fourier-domain anterior segment-optical coherence tomography (AS-OCT) corneal mapping between keratoconic and normal eyes. Patients and methods This prospective case–control study included 51 participants who were divided into two groups: study group A (formed of 50 eyes of 26 keratoconic participants) and control group B (50 eyes of 25 healthy controls of matched age and sex with group A). Maps of corneal epithelial statistics within central 5 mm [S: 2–5 mm (superior), I: 2–5 mm (inferior), minimum, maximum, SD (topographic variability), minimum−maximum], and the total corneal pachymetry maps were assessed by the Fourier-domain AS-OCT system and imaged by Scheimpflug imaging corneal topography for both groups. Results For group A of keratoconic corneas, the attained results are as follows: the mean of epithelial thickness at the center was 50.1±7.98 μm, superior 56.01±6.98 μm, inferior 48.73±5.97 μm, minimum 39.95±9.11 μm, maximum 62.92±8.85 μm, minimum−maximum −22.01±10.91 μm, and topographic variability 6.9±4.2 μm. For group B of healthy control eyes, the mean of epithelial thickness at the center was 52.71±3.71 μm, superior 52.29±3.32 μm, inferior 53.42±3.11 μm, minimum 48.89±3.71 μm, maximum 55.92±3.47 μm, minimum−maximum −6.3 ±3.51 μm, and topographic variability 1.53±0.82 μm. All variables of epithelial thickness between the two groups are significant (P