Purpose To compare 2 lenticule insertion methods currently in use for Descemet stripping automated endothelial keratoplasty (DSAEK). Design Prospective randomized single-masked study. Patients and Methods Twenty patients with Fuchs endothelial dystrophy and pseudophakic bullous keratopathy undergoing DSAEK surgery were included and randomized to the use of either EndoGlide or EndoSerter as a delivery method for the donor lenticule. Post surgery, patients were monitored for up to 1 year. Evaluation included corrected distance visual acuity (CDVA) and refraction. Specular microscopy images were obtained at the 6- and 12-month visits. Complications, including rebubbling rate, graft dislocation, and graft failure, were recorded. Results Twenty eyes were randomized to receive the Tan EndoGlide or the EndoSerter injector for lenticule insertion. Mean patient age was 65.9 ± 8.4 years and 70.3 ± 9.8 years in the Tan EndoGlide and EndoSerter groups, respectively (P =.3). Two eyes in each group needed rebubbling. The mean endothelial cell loss, including the rebubbled eyes, at the 12-month visit was 1093 ± 629 cells/mm2 (range: 239-2109 cells/mm2, mean percentage cell loss 41.2%) and 877 ± 566 cells/mm2 (range: 116-1851 cells/mm2, mean percentage cell loss 31.4%) in the Tan EndoGlide and EndoSerter groups, respectively (P =.45). Mean CDVA did not show a statistically significant difference between the 2 groups at the 6- or 12-month visit. Conclusion The EndoSerter shows comparable results to the Tan EndoGlide. However, further investigation is warranted in order to validate these findings.