Objective To observe the effectiveness, stability and safety of toric implantable collamer lens with a central hole (TICL-V4c)implantation in the treatment of moderate to high myopia with astigmatism. Methods Thirty-five patients (59 eyes) who had undergone TICL-V4c implantation in Beijing Tongren Hospital from November 2018 to December 2020 were collected, and the preoperative and postoperative visual acuity and dioptric variety at 1 week and 1 year were collected and analyzed. Vector analysis of astigmatism was done to observe the effectiveness and safety of correction of astigmatism by the operation, and to record the postoperative complications. Results The UCVA was 0.00 (-0.08, 0.00) at one year postoperatively, and the proportion of eyes with 1.0 or better UCVA was 88.14%. The safety index was 1.20 (1.00, 1.25),and the efficacy index was 1.14 (1.00, 1.20). The postoperative SE was significantly and stably improved. The postoperative mean astigmatism was effectively and stably corrected. After the operation, J0 was significantly reduced, and J45 had no significant change. Conclusions TICL-V4c implantation is effective, stable and safe for moderate to high myopia with astigmatism.