AIM: To determine if there is any difference in long term graft survival between Descemet’s stripping endothelial keratoplasty (DSEK) and penetrating keratoplasty (PK). METHODS: A retrospective 5-year cases analysis of bullous keratopathy secondary to Fuchs’ endothelial dystrophy or pseudophakic bullous keratopathy, receiving either DSEK or PK. A total of 42 DSEK cases and 25 PK cases were included in the analysis. RESULTS: In the 5-year analysis, graft survival rates were very similar in the two groups (DSEK 77.1% vs PK 76.0%, P=0.918, 95%CI: -6.3 to 33.4). Sub-analyses at 1y (DSEK 81% vs PK 95%, P=0.085, 95%CI: -29 to 3.6) and 2y (DSEK 81% vs PK 88%, P=0.381, 95%CI: -25.9 to 11.8) show a trend towards lower survival rates of DSEK vs PK, but the results were not statistically significant. CONCLUSION: Long term 5-year graft survival is similar between the DSEK and PK methods of corneal transplant in Chinese patients with bullous keratopathy.