Purpose <p>This prospective and comparative study assesses the agreement of anterior, posterior, and total corneal astigmatism measurements between swept-source optical coherence tomography (Anterion) and Scheimpflug cameras, Placido disc, and OCT-based tomography (Galilei G6).</p> Methods <p>A total of 59 eyes of 59 patients were assessed using two optical biometers. Anterior, posterior, and total keratometry measurements were obtained, and flat (K1), steep (K2), astigmatic power, and J vectors (J₀ and J₄₅) were compared. Bland–Altman plots and intraclass correlation coefficients (ICC) were used to evaluate agreement and reliability between the devices.</p> Results <p>Statistically significant differences were found for flat keratometry measurements of anterior corneal power (Galilei G6: 43.41 ± 1.78; Anterion: 43.32 ± 1.73) and total corneal power (Galilei G6: 42.41 ± 1.85; Anterion: 42.84 ± 1.81), as well as for steep keratometry of posterior corneal power (Galilei G6: − 6.41 ± 0.38; Anterion: − 6.31 ± 0.30) and total corneal power (Galilei G6: 43.69 ± 1.89; Anterion: 43.91 ± 1.89) (<i>p</i> &lt; .05). In contrast, no statistically significant differences were found for the mean power vector components comparison between the devices. Agreement analysis showed significant proportional bias for cylindrical power and vector components (J₀ and J₄₅) of posterior and total astigmatism. No bias was observed with any of the anterior astigmatism and vector components. ICC showed showed relatively poor reliability (ICC &lt; 0.5) between the device measurements moderate reliability for posterior corneal parameters.</p> Conclusion <p>Anterior, posterior, and total astigmatism measurements between the Anterion and Galilei G6 are not interchangeable.</p>