ObjectiveThis study aimed to assess the prevalence of cataract and associated factors among adults aged 40 years and above in Durame town, Southern Ethiopia.DesignA community-based cross-sectional study was conducted using a systematic random sampling method.SettingThe study was conducted in Durame town, Southern Ethiopia.ParticipantsThe study included 734 adults aged ≥40 years who lived in Durame town for more than 6 months.Main outcome measuresData were collected using face-to-face interviews completed by an interviewer and ophthalmic examinations.ResultsA total of 734 study participants aged 40 years and above were involved. The prevalence of cataract was 29.16% (95% CI: 25.89% to 32.59%). Factors associated with the prevalence of cataract were older age of 70–95 years (adjusted odds ratio (AOR)=8.60, 95% CI: 3.09 to 23.90), being diabetic (AOR=2.27, 95% CI: 1.37 to 3.74), exposure to sunlight (AOR=2.83, 95% CI: 1.45 to 5.53), trauma to eye (AOR=2.39, 95% CI: 1.19 to 4.81), hypertension (AOR=1.86, 95% CI:1.16 to 2.99) and glaucoma (AOR=5.36,95% CI: 3.13 to 9.18).ConclusionThe prevalence of cataract was lower than previous national survey results. Old age, known history of trauma to eye, hypertension, diabetes, exposure to sunlight and glaucoma had statistically significant association with cataract.