Purpose: To compare the efficacy of rigid gas-permeable (RGP) lens and soft hydrogel lens in patients with keratoconus and to assess their impact on quality of life (QoL). Setting: Tertiary care referral center. Materials and methods: A randomized, comparative, clinical interventional trial was conducted in patients with keratoconus. From July 2014 to June 2017, patients were enrolled for this study and were fitted with RGP contact lens (CL) (RoseK© Menicon Limited) or silicone hydrogel lens (Kerasoft© International Limited). The two groups were compared in terms of best spectacle corrected visual acuity (BSCVA), best CL corrected visual acuity (BCLCVA), corneal topography, Schirmer's test, and contrast sensitivity. Quality of life was assessed by asking the patients to fill a self-reported questionnaire. Results: Forty eyes were enrolled and randomized to the Rose-K and Kerasoft groups. The two groups were comparable with respect to the mean patient age, sex, and mean K values. A statistically significant improvement was observed in BCLCVA in both groups at 6 months (p < 0.01). The Kerasoft group had a better comfort score at 6 months’ follow-up compared to Rose K (p < 0.05). In terms of contrast sensitivity, Rose K group fared better than Kerasoft group (p = 0.001). Conclusion: Both Kerasoft and Rose K groups showed improvement in visual acuity. Kerasoft lens users had better comfort and also required less number of trials before final fit. Rose K lens provided a better contrast sensitivity. We conclude that Kerasoft lens can be considered as a good alternative for optical correction of corneal astigmatism in patients with keratoconus, not tolerating RGP lenses.