Objective To evaluate the efficacy and safety in the treatment of age-related cataract by comparing manual small incision sutureless cataract surgery (MSICS) with phacoemulsification (Phaco).Methods In a systematic review and meta-analysis,trials were identified by searching databases for randomized clinically controlled trials on the treatment of age-related cataract by manual small incision sutureless cataract surgery and phacoemulsification.The following databases were searched up to February 2012:Cochrane Library,Embase,PubMed,CBM,CNKI and VIP.The quality of the included trials was assessed and meta-analyses were performed with RevMan 5.1 software.Results A total of 13 randomized clinically controlled trials involving 2870 eyes were included.There were no statistically significant differences in the ratio of postoperative visual acuity ≥0.3 (Z=0.61,P＞0.05),endothelial cell loss (Z=0.78,P＞0.05),or postoperative complications (Z=0.74,P＞0.05).But there were statistically significant differences in postoperative astigmatism between the two groups 6 weeks after surgery (Z=10.16,P＜0.01).MSICS was far more economical and time saving than phacoemulsification.Conclusion Meta-analysis shows that MSICS has equal efficacy and safety compared to Phaco in the treatment of age-related cataract.Because MSICS is far more economical and time saving,it should be recommended for use in basic hospitals in China.