Purpose <p>To describe the demographic, clinical, and ocular characteristics of patients with presumed infectious and non-infectious anterior scleritis at a tertiary referral center in Indonesia and to compare management patterns and visual outcomes between the two groups.</p> Methods <p>We conducted a retrospective cohort study of patients diagnosed with scleritis between January 2019 and December 2023 at Department of Ophthalmology, Dr. Cipto Mangunkusumo National General Hospital. Demographic, clinical, and ocular characteristics, etiology, complications, treatment, and outcomes were reviewed from medical records.</p> Results <p>Sixty-nine patients (96 eyes) were included. The mean age at presentation was 38.5&#xa0;years, and most patients were female. Non-infectious scleritis accounted for 56 eyes (58.3%), whereas 40 eyes (41.7%) were classified as presumed infectious. Presumed tuberculosis-associated disease predominated in the presumed infectious group, whereas idiopathic disease and spondyloarthropathy were common in the non-infectious group. Nodular scleritis was more frequent in the presumed infectious group, whereas diffuse scleritis predominated in the non-infectious group. Anti-tuberculosis therapy was the most common systemic treatment in presumed infectious scleritis, whereas non-steroidal anti-inflammatory drugs, corticosteroids, and steroid-sparing agents were commonly used in non-infectious scleritis.</p> Conclusion <p>Non-infectious scleritis was more common than presumed infectious scleritis, although the proportion of presumed infectious disease was relatively high, likely due to the high proportion of presumed tuberculosis-associated cases. In tuberculosis-endemic settings, these findings underscore the need for careful etiologic evaluation, close follow-up, and multidisciplinary management. Interpretation remains limited by the retrospective design, incomplete follow-up, and limited microbiologic confirmation.</p>