Background: Manual small incision cataract surgery (MSICS) and phacoemulsification are common procedures for cataract surgery these days. Contrary to phacoemulsification, where its machines are expensive to buy and to maintain; demanding expensive surgical consumables and extensive surgical training, MSICS is emerging as a popular technique with all the merits of phacoemulsification along with its wider applicability, safety, easy learning curve, and low cost and machine-independent nature. Because of this, MSICS is being widely practiced in countries like Nepal. Aim of the study: The study aimed to assess the outcome of visual acuity of first-day postoperative patients undergoing MSICS and phacoemulsification group and their effectiveness. Materials and Methods: The retrospective study of the visual outcome of the first day of postoperative patients was compared in a large sample of 2083 patients, including 1492 patients with MSICS and 591 patients with phacoemulsification from January 1 2019 to December 31, 2019. Preoperative and postoperative data were collected and analyzed using MS Excel and IBM SPSS V20 to cross-check the analysis outcomes. Results: The statistical analysis shows the comparable result of good visual acuity (6/6 – 6/18) in both groups. It also revealed that among the two groups, the occurrence of the post-operative complication is more in the phacoemulsification group. Conclusion: In the developing world, MSICS can be taken as a choice because it is cost-effective, machine-independent, and has a reduced chance of postoperative complication. MSICS produces a good visual outcome compared with phacoemulsification.