Levofloxacin 0.5% ophthalmic solution (Cravit, Quixin, Oftaquix) has well established efficacy and tolerability in the treatment of external ocular infections. Levofloxacin 0.5% ophthalmic solution was generally more effective than ofloxacin 0.3% ophthalmic solution in the treatment of external ocular infections, and noninferiority was seen between levofloxacin 0.5% ophthalmic solution and both moxifloxacin 0.5% and tosufloxacin 0.3% ophthalmic solutions in the treatment of bacterial conjunctivitis. Although levofloxacin 0.5% ophthalmic solution administered in the hour prior to surgery did not reduce the incidence of endophthalmitis in patients undergoing intraocular surgery, additional data are needed to examine an optimal preoperative regimen of this antibacterial; preoperative levofloxacin 0.5% ophthalmic solution plus an iodine eyewash reduced positive culture rates in patients undergoing intraocular surgery. Levofloxacin 0.5% ophthalmic solution was well tolerated in the treatment of external ocular infections. Thus, levofloxacin 0.5% ophthalmic solution remains an important option in the treatment of bacterial conjunctivitis and other external ocular infections, as well as for perioperative use.