Purpose <p>To evaluate the effect of topical autologous serum (AS) on corneal healing following metallic corneal foreign body (CFB) trauma.</p> Method <p>Following the removal of CFBs with a 26-gauge needle, patients were randomly divided into two groups. Group 1 patients received topical moxifloxacin and preservative- free artificial tears, while Group 2 participants used these drops in addition to AS five times a day. Patients were followed until their corneal epithelial defects were closed. The baseline size of the epithelial defects was measured, and corneal densitometry measurements using Pentacam HR (Oculus, Wetzlar, Germany) were obtained before treatment. Epithelial healing rates and post-treatment corneal densitometric measurements were compared.</p> Results <p>Group 1 comprised 41 male participants with a mean age of 36.1 ± 13.3 years, and Group 2 consisted of 42 male participants with a mean age of 34.9 ± 11.5 years. No statistically significant difference in age distribution was observed between the groups (<i>p</i> = 0.229). Complete epithelial closure occurred within 3.51 ± 1.03 days for Group 1 participants, whereas Group 2 participants achieved complete closure within 2.19 ± 1.10 days. A significantly faster rate of epithelial closure and a notably shorter duration were observed in Group 2 (<i>p</i> = 0.002 and <i>p</i> &lt; 0.001, sincerely). Post-epithelial healing corneal densitometry measurements revealed significantly lower values in participants utilizing AS (<i>p</i> = 0.007).</p> Conclusion <p>The use of AS accelerated corneal defect healing following metallic CFB removal and resulted in a greater reduction in corneal densitometry values compared with standard treatment with topical antibiotics and artificial tears.</p>