Abstract: Objective To compare the efficacy and safety of multifocal rigid gas permeable （MFRGP） lenses versus single-vision rigid gas permeable （SVRGP） lenses in controlling myopia progression in adolescents aged 8 to 14 with high myopia. Methods A total of 120 adolescent patients with high myopia, who visited the Guangdong Provincial People’s Hospital between 2021 and 2023, were enrolled. Based on their myopia correction method, the patients were divided into the MFRGP group （58 cases） and the SVRGP group （62 cases）. Follow-up was conducted for 1 year, during which we assessed their spherical equivalent （SE）, annual increase of axial length （AL）, visual acuity with lenses, residual SE, and the incidence of corneal adverse reactions. Results Both groups showed an increasing trend in SE and AL. In the MFRGP group, the SE change was （-0.40±0.31） D and and the AL growth was （0.25±0.13） mm, while in the SVRGP group, the SE change was （-0.62±0.37） D and the AL growth was （0.38±0.27） mm. The differences in the SE and AL increment changes between and within the two groups were statistically significant （all P < 0.05）. At 12 months, the MFRGP group had better corrected visual acuity than the SVRGP group LogMAR： +0.02±0.06 vs. +0.10±0.09, P < 0.001, and the residual SE was significantly lower than that in the SVRGP group （-0.29±0.31）D vs.（-0.78±0.71）D,P = 0.002. No severe complications occurred in either group, and although the MFRGP group had a slightly higher probability of adverse reactions compared with the SVRGP group, the difference was not statistically significant and could be alleviated with intervention. Conclusions MFRGP is superior to SVRGP in controlling the progression of high myopia in adolescents, and its safety is controllable. MFRGP shows better clinical efficacy in myopia prevention and control.