AIM: To investigate the association between hypertension, diabetes and the risk of age-related cataract (ARC) in middle-aged and elderly men. METHODS: A hospital-based case control study was conducted. Cases (n=360) were patients with cataract 45-85 years old, and controls (n=360) were patients who had been admitted to the same hospital for diseases not related with cataract. Cases and controls were matched with 1∶1. All subjects were interviewed using a structured interviewer-administrated questionnaire that included information on socio-demographic characteristics, lifestyle habits and detailed medical history. Blood pressure and blood glucose of study population were measured. Multiple logistic regression model was used to derive odds ratios (OR) and 95% confidence intervals (CI) for the association between hypertension and diabetes, and ARC. RESULTS: After adjusted for age and gender, hypertension was significant positively related with ARC (OR=1.573, P=0.005). Compared with normal systolic blood pressure,systolic blood pressure ≥180mmHg increased the risk of onset (OR=2.812, 95%CI: 1.450-5.455, P=0002). The duration of hypertension was associated with an increased risk of ARC, especially those men for 10 to 20 years (OR=1.867, 95%CI: 1.053-3.307, P=0.033). Similarly, there was a positive association between diabetic patients and ARC (OR=2.151, 95%CI: 1.470-3149, P<0.001). The risk of ARC in diabetes duration <10 years and 10 to 19 years significantly increased (OR =2.374; 95%CI: 1.502-3.752, P<0.001 and OR =2.683; 95%CI: 1.267-5.683, P=0.010 respectively). CONCLUSION: Hypertension and diabetes may increase the prevalence rate of ARC. Interventions to modify these risk factors, especially in populations in which they are highly prevalent, may have implications to control visual loss from cataract, which is the first cause of blindness worldwide.