AIM: To evaluate the visual quality of cataract patients of high myopia with posterior staphyloma after phacoemulsification and intraocular lens(IOL) implantation, and analyze the reasons. METHODS:This study comprised cataract patients of high myopia with posterior staphyloma(Group A) and cataract patients of high myopia without posterior staphyloma(Group B)and cataract patients of emmetropia(Group C) .Postoperative visual function, including uncorrected distance visual acuity (UCDVA) and best-corrected distance visual acuity(BCDVA) were evaluated 3 days and 6 months postoperatively. Contrast sensitivity, fundoscopy and patients self satisfaction in the 3 groups were also compared. The relationship of vision and the axial length was also evaluated in Group A. RESULTS: Of the 545 eyes, 91 eyes were in the Group A and 227 eyes were both in Group B and C. The Group B and C had statistically significant better UCDVA and BCDVA than Group A from 3 days postoperatively to the final follow-up (both P<0.05). Group C had statistically significant better UCDVA and BCDVA than Group B at 3 days postoperatively (P<0.05). There were no statistically significant differences in UCDVA or BCDVA between Group B and C at 6 months postoperatively. The Group C had statistically significantly better contrast sensitivity than Group A and B; Group B had statistically significantly better contrast sensitivity than Group A (all P<0.05). After statistical test, it was testified that there was negative correlation between axis length of eye and postoperative vision in cataract patients of high myopia with posterior staphyloma. Patients in Group A and B reported being more satisfied than those in Group C(both P<0.05), but there were no significant differences between Group A and B. CONCLUSION: The visual quality of cataract patients of high myopia with posterior staphyloma after phacoemulsification and IOL implantation is worse than that of high myopia without posterior staphyloma and emmetropia. It is directly related to the posterior segment pathological changes in high myopia.