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To investigate anterior segment parameters (ASPs) and dry eye disease (DED), including the status of the meibomian glands, in patients with acromegaly. In this cross-sectional, comparative study, 36 acromegaly patients and 40 healthy sex- and age-matched controls were included. Participants received a comprehensive ophthalmological examination, including intraocular pressure measurements with Goldmann applanation tonometry (IOP GAT) and central corneal thickness corrected intraocular pressure (IOP CCT) measurements, and were evaluated for ASPs and DED. For ASPs, white-to-white (WTW), apical (ACT) and thinnest corneal thickness (TCT), corneal volume (CV), keratometry readings (K 1 , K 2 , and K mean), anterior chamber depth (ACD) and volume (ACV), and iridocorneal angle (ICA) were obtained via Sirius topography. DED was assessed with Schirmer's test, tear breakup time (TBUT), and Ocular Surface Disease Index (OSDI) scores. Meibography scores (MSs) were obtained with the Sirius topography device. Patients had higher mean IOP GAT (P =.006), IOP CCT (P =.01), ACT (P =.024), and TCT (P =.005) but narrower ICA (P =.014) than controls. Although Schirmer's test did not differ between the groups (P =.442), patients had higher OSDI (P <.001), higher MS (P =.001), and shorter TBUT (P =.002). Patients with acromegaly have greater IOP, greater corneal thickness, but narrower ICA than healthy individuals, as well as DED with increased MSs, which suggests meibomian gland dysfunction. • Acromegaly patients have thicker cornea and narrower iridocorneal angle than controls. • Dry eye disease in conjunction with loss of meibomian glands occur in acromegaly. • Clinicians should be aware of anterior segment status in patients with acromegaly. [ABSTRACT FROM AUTHOR]