The two immunosuppressants most used topically in ophthalmology are cyclosporine (CS) and tacrolimus (TL). Their mechanism of action is similar, but the TL is ten to a hundred times more powerful than the CS. We reviewed the studies found in the literature on the use of topical TL and described them, as follows, divided by indication of use. Topical TL is effective and safe against inflammatory and immunological processes of the ocular surface, although it is less powerful than corticosteroids, it has fewer side effects.