Objective To investigate the medium- to long-term effects on visual acuity for poverty patients undergoing free cataract surgery from 2013 to 2014 in Anhui Province. Methods In this cross-sectional survey, geographically defined cluster sampling was used to randomly select 1 140 cases in 8 basic sample units (Counties of Shucheng, Lujiang, Qianshan, Langxi, Taihe, and Lingbi, and District Guichi of Chizhou, and District Qiaocheng of Bozhou). The duration between the investigation and cataract operation was 3 to 21 months. All cases received comprehensive ophthalmologic examination, including visual acuity, slit lamp examination, ophthalmoscopy, intraocular pressure (IOP), and optometry. Results The investigation included 718 cases (985 eyes) (83.0%). Best corrected visual acuity (BCVA) was ≥0.05 in 940 eyes (95.4%), ≥0.3 in 826 eyes (83.8%), and ≥0.5 in 670 eyes (68.0%). Intraocular lenses (IOLs) were implanted in 979 eyes (99.4%). The cornea was clear in 963 eyes (97.8%), and the pupil was intact in 904 eyes (91.8%). The location of intraocular lens was central in 953 eyes (96.8%), and the posterior capsule was transparent in 623 eyes (63.2%). The average IOP was 14.3±4.9 mmHg. Ametropia was found in 284 eyes (28.8%). The most common complaint was tearing [313 eyes (31.8%)]. Eyes with BCVAs of ＜0.05 had age-related macular degeneration, posterior capsular opacification (PCO), high myopic retinopathy, corneal opacity, and optic nerve atrophy. Eyes with BCVAs less than 0.3 had age-related macular degeneration, PCO, high myopic retinopathy, corneal opacity, and diabetic retinopathy. Conclusion More than 80% of poverty patients in Anhui Province after free cataract surgery had been recovered to normal vision. The most common complications were residual refractive error and PCO. The major causes of blindness and low vision after cataract surgery were pre-existed retinal diseases.