During the past ten years, the frequency of bilateral simultaneous intraocular surgery has increased and the majority have been cataract extractions. Two hundred and fifty-one patients have had this operation. The pre- and postoperative acuities and the complications have been tabled and the assessment indicates that this is a safe and successful approach considering the age of the patients and the associated pathology. There was no bilateral operative disaster. Of 232 patients whose post-operative acuities were recorded and are known, no patient had worse binocular acuity following bilateral simultaneous cataract extraction. Hospital time in the clinics, the ward and the operating theatre has been saved and the patients are more quickly returned to balanced binocular vision.