To investigate the risk factors and etiologies involved in the development of Phylectenular Keratoconjunctivitis (PKC) at Sirte University, the Ibsen teaching Hospital Libya. Methods: Patients with PKC were recruited from the Ibsen teaching Hospital between Jan 1st and Jun 31st 2022. Patients underwent complete ophthalmologic examinations with 4 laboratory tests and investigations: 1) Tuberculin test, 2.) Throat Swabs, 3) Stool Analysis, and Conjunctival Swabs. Patients with any ocular diseases, use ocular medication, or history of previous surgeries or trauma were excluded. Results: Fifty patients with PKC were included; with age range: 3- 19 years (SD 5.09). There were 37 females (74%), and 13 males (26%). Lesion limbus location distributions were as follows: temporal in 26 cases (52%), nasal in 16 cases (32 %), inferior 3 cases (6 %), and superior 5 cases (10 %). Tuberculin test was positive in 4 cases (8%) with mean age 7.25 + 4.19 (range: 3-12 years), and, 3 cases were females (75%). Throat swab was positive in only 4 cases (8%) with mean age 8.67 +1.53 (range: 7-10 years), 3 cases were males (75%). Stool Analysis was positives for intestinal parasites in 14 cases (28%), their mean age was 11.38 +5.68 years (range: 3-19). Hymenolepis nana was detected in 11 cases (78.57%) of which 9 were female (64.28%), and Ascaris was detected in 3 male cases (21.43%). conjunctival swab was positive for staphylococci in 30 cases (60%) with a mean age of 10.33 + 4.92 years and 22 were females (73.33 %). Conclusion: In this study, conjunctival bacteria appeared to first risk factor for developing PKC followed by intestinal parasitic infestations. Two infections that may require further attentions to reduce the incident of PKC