OBJECTIVES: To determine the effect of cataract surgery on the occurrence of falls and mobility and balance problems in older adults with cataract. DESIGN: Longitudinal follow-up study. SETTING: Clinical Research Unit, University of Alabama at Birmingham. PARTICIPANTS: Persons aged 55 and older with a cataract were recruited from 12 eye clinics in Alabama from October 1994 through March 1996. Participants were classified into two groups: those who had cataract surgery (surgery group, n = 122) and those who had not (no-surgery group, n = 92). MEASUREMENTS: At baseline and 1-year follow-up visits, information on the occurrence of falls and mobility and balance problems was collected based on subjects' recall of events during the prior 12 months. RESULTS: After adjusting for demographic, behavioral, medical, and visual characteristics, there was no difference between the two groups in the likelihood of falling (risk ratio (RR) = 0.96, 95% confidence interval (CI) = 0.64-1.42) or in having mobility (RR = 0.81, 95% CI = 0.55-1.18) or balance difficulties (RR = 0.71, 95% CI = 0.37-1.39). CONCLUSION: Cataract surgery had no association with the occurrence of falls or mobility or balance problems in independently living older adults with a cataract. © 2006, Copyright the Authors.