Background <p>to evaluate corneal optical densitometry (COD) and its associations with age, refractive error, central corneal thickness (CCT), anterior chamber depth (ACD), and corneal curvature in healthy Upper Egyptian subjects.</p> Methods <p>This prospective cross-sectional study included 379 eyes of 379 healthy subjects aged 16 years or older. All participants underwent a comprehensive ophthalmologic evaluation. Corneal optical densitometry was assessed using the Oculus Pentacam, which measures COD in grayscale units (GSU) across four annular zones and three lamellar layers. Cases with a history of corneal or intraocular surgery, habitual contact lens use, or systemic diseases were excluded.</p> Results <p>The mean COD over the entire cornea (0–12 mm) was 16.1 ± 2.6 GSU. A strong positive correlation was found between age and COD across all zones and layers (<i>p</i> &lt; 0.001). Negative correlations were observed between COD and mean refractive spherical equivalent (MRSE) in the 10–12 mm zone (<i>p</i> &lt; 0.001) and between COD and CCT in the 0–2 mm zone (<i>p</i> = 0.004). Anterior chamber depth (ACD) was negatively correlated with COD in multiple zones (<i>p</i> &lt; 0.05). Positive correlations were identified between COD and keratometry readings (K_m and K_max) across all zones and layers (<i>p</i> &lt; 0.001).</p> Conclusion <p>This study highlights the associations between corneal optical densitometry and basic population characteristics in healthy Upper Egyptian subjects. This enhances understanding of factors influencing corneal transparency and underscores the importance of considering these variables in clinical and research settings.</p>