Purpose: To evaluate small incision cataract surgery visual outcomes and associated risk factors in a tertiary eye care center in Bhutan. Methods: This was a hospital-based prospective longitudinal study. A total of 310 patients who met the eligibility criteria were included in the study. Results: The mean age of the patients was 68.36 (SD: 12.74 years), and 157 (50.6%) were male. 285 (91.94%) of the cataract-operated eyes had best-corrected vision greater than 6/60, while 25 (8.06%) of the eyes had vision less than 6/60. 47 individuals (15.16%) had pre-existing ocular co-morbidity. Intraoperative complications were seen in 19 eyes (6%). At the 6-week follow-up visit, based on best-corrected visual acuity (BCVA), 90.65% had a good outcome. Analysis of multiple logistic regression showed that patients with preoperative ocular comorbidities (OR 50.92; 95% CI 10.23, 253.37) and those with operative complications (OR 16.59; 95% CI 3.54, 77.70) were significantly associated with poor visual outcome. Conclusions: This study shows that cataract surgery can restore good visual acuity. However, patients should be followed up on for a longer period, and greater emphasis should be paid to monitoring outcomes after cataract surgery.