To report a rare case of corneal perforation in reactive arthritis and review the scientific basis for it. A case report. A 22-year-old male patient presented with redness, foreign body sensation, and blurred vision associated with knee and lumbar arthritis after an episode of urethritis was diagnosed with reactive arthritis (ReA). Ophthalmological examination revealed keratitis and corneal perforation at the time of admission. The patient received antibiotic drops and systemic steroids and underwent a corneal patch graft, which improved his visual acuity and outcome; however, he developed chronic arthritis and had to be treated with infliximab. The classical ocular manifestations of ReA are conjunctivitis, anterior uveitis, keratitis, and scleritis; however, this case report demonstrates a rare but severe presentation of ReA that should be considered.