AIM:To evaluate the clinical therapeutic effect of small incision horizontal manual fragmentation and phacoemulsification.·METHODS: A total of 249 eyes 210 cases underwent small incision horizontal manual fragmentation and intraocular lens implantation. 227 eyes 199 cases were performed phacoemulsification and intraocular lens implantation. Visual acuity, astigmatism and complica-tion were observed and analysed.·RESULTS: One month after operation, the visual acuity ≥0.5 was in 205 eyes(82.3%) in small incision group and 191 eyes(84.1%) in phacoemulsification group. The diffe-rence between the groups was not significant. 3 months after operation, the astigmatism degree was 0.95±0.51D in small incision group and 0.89±0 .78D in phacoemulsifi-cation group and the difference was not significant. The corneal edema disappeared 1 month after operation. There were no serious complications.·CONCLUSION: The clinical therapeutic effect of small incision horizontal manual fragmentation and phacoemul-sification is similar. The small incision horizontal manual fragmentation has been proved to be safe and effective.