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PURPOSE To assess the long-term effectiveness and safety of photorefractive intrastromal corneal crosslinking (CXL) in patients with low myopia. SETTING Ruhr University Eye Hospital, Bochum, Germany. DESIGN Prospective case series. METHODS Healthy eyes with myopia were treated with photorefractive intrastromal CXL using the Mosaic System. Riboflavin 0.1% solution (VibeX Rapid) was topically administered, followed by 365 nm ultraviolet-A (30 mW/cm2) irradiance. Efficacy was assessed by the uncorrected distance visual acuity (UDVA), manifest refraction spherical equivalent (MRSE), and keratometry. Safety was assessed by corrected distance visual acuity (CDVA), slitlamp biomicroscopy, endothelial cell count, and adverse event rates. RESULTS Fourteen patients (24 eyes) with a mean age of 35.7 years were included. At all follow-ups, a statistically significant improvement in UDVA was observed (all P < .001). The CDVA progressively improved from 1 month postoperatively and a statistically significant improvement was achieved at 12 months (P < .001). The average reduction in manifest sphere was 0.90 diopter (D) ± 0.40 (SD) by 12 months. There were no significant differences in mean manifest sphere and MRSE at 3, 6, or 12 months. Compared with baseline, significant reductions in corneal curvature were also observed at all follow-ups (all P < .05). There were no significant changes in endothelial cell density (P = 1.00) or number of cells (P = .95) at 12 months postoperatively, and no adverse events were reported. CONCLUSION Photorefractive intrastromal CXL was a safe and efficacious treatment of refractive error in patients with low myopia.