The aim of this study was to explore the correlation between the parameters associated with the prevention and management of myopia and cylinder power (CP) progression in individuals who wear defocus incorporated multiple segments (DIMS) lenses. In total, 179 children (6-12 years old) prescribed DIMS lenses for 1 year were enrolled in this retrospective cohort study. Cycloplegic refraction, spherical equivalent (SE), axial length (AL), CP, and corneal astigmatism (CA) were measured. The relationship between myopia and CP progression was assessed using binary logistic regression analyses, stratified analyses, and interaction tests. These 179 DIMS lens wearers were, on average, 9.51 +/- 1.48 years old, and 51.4% were male. In total, 24.02% of these participants had CP progression >= 0.25 D within one year. A fully-adjusted binary logistic regression analysis revealed that Delta SE (odds ratio (OR) = 1.73, 95% CI (1.32, 2.27), P < 0.001) and CA at admission (OR = 1.17, 95% CI (1, 1.36), P = 0.049) were associated with CP progression following adjustment for potential confounding factors. Interaction analysis revealed no significant interactive relationships. Our results showed a significant positive association between Delta SE and CP progression in DIMS lens wearers. Furthermore, baseline CA was also associated with Delta CP in participants over the course of the study. This suggested that myopia progression and baseline CA levels contribute to variations in CP progression. This study helps optimize astigmatism control in preventing and controlling myopia in DIMS lens wearers.