Objective To investigate the safety and efficacy of femtosecond laser-assisted cataract surgery compared to conventional cataract surgery. Methods Eighty-seven patients （114 eyes） were enrolled in this prospective cohert study between December 2013 and May 2014 in Shanxi Eye Hospital. Forty-four patients （60 eyes） underwent femtosecond laser-assisted cataract surgery. Forty-three patients （54 eyes） underwent 2.2 mm coaxial microincision cataract surgery. Femtosecond laser-assisted cataract surgery involved anterior capsulotomy， corneal incision and lens fragmentation based on optical coherence tomography-guided treatment mapping. An aspheric intraocular lens （SN60WF） or a multifocal intraocular lens （SN6AD1） was implanted based on the patient′s preference. Intraoperative complication rates and phaco energy parameters were recorded. Visual acuity， central corneal thickness and corneal endothelial cell loss were analyzed and the measurements were compared between the two groups. Results There were no statistically significant differences in visual acuity and best corrected visual acuity （BCVA）. The reduction in the mean number of endothelial cells was lower in the femtosecond laser-assisted cataract surgery group， but the difference was not significant. U/S total time was reduced to 30% compared to the conventional cataract surgery group （t=-2.739， P＜0.01）. Cumulative dissipated energy （CDE） was reduced 49% （Z=-2.979， P＜0.01）. In the femtosecond laser-assisted cataract surgery group， an incision was easily opened in 78%； incisions for the remaining patients were more difficult to perform. 93% of the capsule buttons were free floating and 7% were incomplete and a manual capsulorrhexis was required to complete the capsulotomy. Conclusion Femtosecond laser capsulotomy and lens fragmentation significantly reduce ultrasound use compared to conventional surgery. The new surgery appears to be safer and more efficient than conventional cataract surgery in the short term postoperatively.