BACKGROUND; Ulcerative keratitis is a common cause of mono ocular blindness and it can perforate the eye and hence permanently impair vision. It is one of the late treated and had to diagnose due to the fact that it affects one eye. The causes, risk factors and treatment options of ulcerative keratitis have not been recently studied. In addition, the impact of ulcerative keratitis on visual acuity also has not been explored. This may subsequently lead to lack of enough knowledge on degree of visual impairment of ulcerative keratitis and poor quality of life, due to poor vision. The disease has lead to increase of preventable blindness of eyes in Tanzania and most developing countries. OBJECTIVES: The aim of this study was to determine degree of visual impairment, demographic characteristics, presumptive causes and treatment modalities of ulcerative keratitis patients by eye department kcmc Kilimanjaro, Tanzania from January 2015 to April 2016. METHODS: This was a hospital based retrospective crossectional study which was conducted at KCMC eye department from May to June 2016, aiming at establishing the degree of visual impairment among ulcerative keratitis patient. The study was conducted to a population of patient who were admitted and treated with ulcerative keratitis at eye department of KCMC in 2015. Convenience sampling for patients with ulcerative keratitis attended KCMC eye department in 2015. Data processing and analysis was done using SPSS version 16 and study approval was through the KCMC ophthalmology head of department and dean faculty of medicine. RESULTS: A total of 120 patients with ulcerative keratitis were evaluated. 65 (54.2%) patients were male and 55 (45.8%) were female. 70 (59.8%) patients worked as farmers and livestock keepers. Age of patients ranged 1 to 95 years with median age 34 years. History of ocular trauma was present in 66 (57.9%) patients and eye infections 42 (36%). Surgical management was offered to 63 (52.5%) patients and conservative medical management 57 (47.5%) patients. Among 120 patients 22.9% of affected eyes had moderate and severe visual impairment. Most of affected eyes 64 (52.5%) had blindness. CONCLUSION: Monocular visual impairment and blindness is high in ulcerative keratitis disease. The leading cause of ulcerative keratitis is trauma while eye infections being the second cause. Surgical management is the leading management offered to ulcerative keratitis patients.