AIM:To evaluate the effect of phacoemulsification and intraocular lens implantation under topical anesthesia on high myopia with cataract. METHODS:In a retrospective study, 60 cases (88 eyes ) of high myopia with cataract underwent phacoemulsification and intraocular lens (IOL) implantation under topical anesthesia. Preoperatively, best-corrected visual acuity (BCVA) ranged from light perception to 0.04 in 40 eyes, from 0.05 to 0.25 in 39 eyes and from 0.3 to 0.4 in 9 eyes.The spherical equivalent ranged from -6.0D to -25D. The eye axial length ranged from 26.05 to 33.4 mm（<30mm，n=69； ≥30mm,n=19）. All cases were followed up for 1 to 3 months. RESULTS:All of the 88 eyes accepted folding IOL implantation，spherical IOL in 46 eyes,aspherical IOL in 39 eyes, and multifocal IOL in 3 eyes,their visual acuity improved in all cases. BCVA achieved 0.5 or better in 54 eyes（61%），0.3 or better in 73 eyes（83%）and 0.05 or better in 83 eyes（94%）. No severe complications were observed. CONCLUSION:Phacoemulsification and folding IOL implantation under topical anesthesia is effective and safe,it is an ideal proceduce for high myopia with cataract.