Objective To evaluate the efficacy and safety of topical murine nerve growth factor (mNGF) eye drops in the treatment of neurotrophic keratitis (NK). Methods Eighteen patients with NK were collected from the ophthalmology outpatients in Sichuan Provincial People′s Hospital between April and September 2025. All patients received topical mNGF eye drops at a concentration of 20 μg/ ml. Corneal epithelial defect diameter, corneal sensation and changes in corneal nerve fibers were assessed. Results Before treatment, the median maximum diameter of corneal epithelial defects was 3. 70 (2. 65, 7. 05) mm. After treatment, the defect diameter was significantly reduced (P< 0. 001). The corneal healing rates in the 4th and 8th weeks were 66. 7% and 87. 50%, respectively. After 4 weeks of treatment, total nerve density, main nerve density, branch nerve density and total nerve number were all significantly increased compared with baseline. The median corneal sensation was 5. 00 (1. 85, 9. 13) mbar at baseline and improved to 1. 60 (0. 80, 2. 40) mbar in the 8th weeks after treatment (P <0. 001). Conclusions Topical application of mNGF eye drops effectively promotes the corneal epithelial defect healing in patients with NK. It also improves the corneal sensation, and facilitates the regeneration of corneal nerves.