AIM:To observe the clinical efficacy of small incision non-phacoemulsification and intraocular lens(IOL) implantation in high degree axial myopia cataract, and analyse related factors to postoperative visual acuity. METHODS: One hundred and eighty-six eyes of 158 patients with axial length ≥26mm of high myopia underwent small incision non-phacoemulsification and IOL implantation. The postoperative visual acuity and intraoperative and postoperative complications were observed in the postoperative follow-up of 6 months. RESULTS: Three months later,uncorrected visual acuity ≥0.5 was in 145 eyes(78%), 0.1- 0.4 in 33 eyes(18%), <0.1 in 8 eyes (4%); complications included posterior capsule rupture in 11 eyes, endothelial edema in 19 eyes, retinal detachment in 3 eyes, posterior capsular opacification in 13 eyes in varying degrees. CONCLUSION: The efficacy of small incision non-phacoemulsification and IOL implantation for high axial myopia cataract, is very good. It is an ideal surgical method with high saftety.