Refractive surgery has evolved significantly in recent years, offering an expanding variety of available treatments. As a surgeon, the goal is to strive for the best clinical results and ensure high patient satisfaction. All modern-day refractive surgery procedures are known to result in both excellent outcomes and high satisfaction rates. Nonetheless, a small percentage of patients may be dissatisfied after their refractive procedure. Patient satisfaction is influenced by various factors, including subjective quality of vision and patient expectations. These factors have a complex relationship in terms of patient satisfaction. For example, the clinical outcome does not always directly correlate with the subjective outcome. Comprehensive preoperative patient counseling is essential to attain realistic patient expectations, taking individual procedure-related risk factors into account. If a complication occurs, it is crucial to promptly inform the patient and guide them closely in the postoperative phase.