Surgery for cataract blindness, a major health problem, is undergoing a rapid transition. This study characterizes cataract surgery in India in terms of practice setting and surgical procedure. A survey questionnaire was mailed in December 1992 to 4356 members of the All India Ophthalmological Society, resident in India, requesting data on cataract surgery cases within the past 12 months. Two thousand one hundred thirty-four (49%) ophthalmologists responded to the survey. Of the 1,023,070 cataract cases reported, two-thirds were private patients. Among private patients, 26.0% received extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation and 20.7% received ECCE without an IOL. Among patients operated under government auspices, 9.1% received ECCE with IOL and 22.4% received ECCE without IOL. Overall, 82.8% of active surgeons reported experience with the ECCE procedure. The cataract case load in the private sector and the frequency of ECCE, with or without IOL implantation, among both private and government-operated cases is greater than previously recognized.