In this dedicated chapter, the visual tapestry of congenital conditions unfolds through detailed clinical photographs. This section highlights the varied presentations of corneal dystrophies, illustrating their unique patterns and inheritance traits. Secondary abnormalities affecting the infant cornea, such as those due to intrauterine infections like syphilis, are depicted with stark clarity, underscoring the importance of early detection and intervention. Images of congenital corneal keloid provide a rare view of this anomaly, while limbal dermoids are showcased for their classic limbus involvement. Congenital corneal anesthesia’s absence of reflexive blinking is elucidated through examples of its consequences. The ocular manifestations of congenital glaucoma, including Haab’s striae and buphthalmos, are visually chronicled, highlighting the disorder’s impact on the developing eye. Additionally, the atlas captures the effects of birth trauma and metabolic disorders on corneal and scleral structures. This chapter offers an indispensable visual guide for clinicians and educators in understanding these complex congenital conditions affecting the anterior segment of the eye.