BACKGROUND in developing countries congenital cataract has become an important cause of treatable blindness in childhood. However, difficulty in correcting aphakia is one of the reasons for poor visual outcome. OBJECTIVE to determine the visual outcome after extra capsular cataract extraction and intra ocular lens implant and factors militating against good visual outcome in children. METHODS a prospective interventional study of cataract extraction in children with intra ocular lens implant. Extra capsular cataract extraction with intra ocular lens implant was performed using the superior limbal approach. Polymethyl Methacrylate lenses were inserted. Posterior capsulotomy was done with a 25G needle bent at the tip in 26 eyes. RESULTS thirty two eyes of twenty five children aged between 4 months and 16 years were operated. Extra capsular cataract extraction with posterior chamber intraocular lens implant was done in 27 (83.4%) eyes, plain extra capsular cataract extraction in 3 (9.4%) eyes, extra capsular cataract extraction with anterior chamber intraocular lens implant in 1 (3.1%) eye and vectis extraction in 1 (3.1%) eye. Twenty six eyes had primary posterior capsulotomy. Thirty-two (100%) eyes and 15 (60%) children were blind before surgery. Result of post operative visual acuity in 18 children after refraction was 6/18 or better in 4 (22.2%) children 6/24-6/60 in 11 (61.1%) and< 3/60 in 3 (16.7%) children. CONCLUSIONS visual rehabilitation following extra capsular cataract extraction with Intra Ocular Lens Implant is encouraging in children.