BACKGROUND Myopia has been identified as a risk factor for globe perforation during regional anaesthesia for cataract surgery. We conducted this study to evaluate efficacy of single injection percaruncular peribulbar anaesthesia for phacoemulsification in patients with axial myopia. METHODS Eighty patients with axial myopia received percaruncular peribulbar anaesthesia and were evaluated for incidence of major or minor complications. Also surgeon and patients' satisfaction and their comment on operative conditions were noted. RESULTS Of the 80 patients 51 patients had posterior staphylomas. About three quarters of the patients developed adequate akinesia in 10 min. Remaining 25% received second injection with the same technique but with less volume after which the percent of patients with adequate akinesia rose to 91%. Adequate analgesia developed in almost all patients and only in one patient, intravenous analgesia was necessary to complete the operation. All operations were completed uneventfully. No perforations or penetrations were recorded and no other major complications were encountered. About 97% of the surgeons and 96% of the patients found the operative conditions satisfactory. CONCLUSIONS Using single injection percaruncular peribulbar local anaesthesia for phacoemulsification in patients with axial myopia is an effective technique.