Nocardia asteroides has been reported as the cause of keratitis in only 7 cases and of other ocular disease in another 12 cases. We report a case of N. asteroides keratitis that presented 3 weeks after rural trauma and progressed despite trials of appropriate antibiotics. Seven weeks after the origianl injury a successful conjunctival flap was placed over the cornea. The morphology and the sensitivity testing of N. asteroides to antibiotics appears necessary before reliable information can be obtained for clinical use. Moreover, our case did not show the relatively benign course of other reported cases of nocardia keratitis.