Objective To analyze visual outcomes and factors related to the visual outcomes in cataract patients with high myopia. Methods Forty-six patients were included in this retrospective study （myopia ≥-6.00 D and axial length ≥26 mm， with opacity of the lens）. Best corrected visual acuity （BCVA）， severity of the cataract， direct fundus analysis and analysis of fundus photos were investigated before and after phacoemulsification and implantation of an intraocular lens （IOL）. Correlation and stepwise regression analysis were used to identify the predictive factors. Results In correlation analysis， the BCVA and myopia were assessed before phacoemulsification； cataract severity， axial length， clarity photos of fundus and fundus disease were correlated with BCVA after phacoemulsification. In stepwise regression analysis， the BCVA after phacoemulsification correlated with BCVA before surgery （P＜0.01） and fundus diseases （P＜0.01）. Conclusion The BCVA before surgery and the fundus diseases were important factors influencing visual outcome and were important parameters for predicating visual outcomes in cataract patients with high myopia.