·AIM:To discuss the manual small incision cataract surgery under small pupil.·METHODS:Totally 30 patients 38 eyes with cataracts underwent the manual small incision cataract surgery and intraocular lens implantation.Different ways were performed to dilate the small pupils during the surgery and the cataract was extracted smoothly.·RESULTS:The visual acuity of 16 eyes(42%)was better than 0.5.The visual acuity of 19 eyes(50%)was between 0.5 and 0.3.The visual acuity of 3 eyes(8%)was lower than 0.3.No complication was found in all cases.·CONCLUSION:Manual small incision cataract surgery is a safe and effective way to solve cataract in small pupils.·