In this study, we aimed to explore the sex differences in myopic cornea using corneal stromal removed by small incision lenticule extraction (SMILE) surgery. The corneal stroma of highly myopic female and highly myopic male were subjected to proteomic assays. The total number of proteins in the cornea and the proteins specifically expressed in the two groups were counted, and the differentially expressed proteins in the two groups were identified by expression fold change >2 and P value <0.05, and volcano plots were constructed, functional enrichment analysis, and molecular interaction were implemented. Finally, 10 samples from each group were analyzed. 27 down-regulated proteins and 27 up-regulated proteins in the FH group, of which 23 proteins were up-regulated by a factor of 2-10 and 4 proteins were up-regulated by a factor of greater than 10. And the increased expression of proteins associated with extracellular matrix and collagen I, III, V, and VIII in female patients, and the TGF-β1/Smad3 pathway was an important pathway obtained from functional analysis. The findings of this study may help to identify sex differences that may exist in myopic corneas，and may help to further explore the pathways of myopia development and thus provide ideas for future treatments.