Objective In this study, we aimed to determine the prevalence of visually significant cataract and associated factors among older people attending community ophthalmic services in the central Gondar Zone, Northwest Ethiopia. Methods We conducted a community outreach-based cross-sectional study among adults aged ≥40 years in the central Gondar Zone from 30 May to 15 June 2021. We used systematic random sampling to select study participants. Interviewer-administered questionnaires and ocular examinations were performed and the data recorded. We applied binary logistic regression to identify factors associated with visually significant cataract. Results A total of 821 participants were included, with median age 57 years. The prevalence of visually significant cataract was 29.1% (95% CI: 26.1–32.0). Age ≥80 years (adjusted odds ratio [AOR] = 16.9; 95% CI: 7.5–38.4), rural residence (AOR = 1.7; 95% CI: 1.02–2.7), unmarried status (AOR = 1.9; 95% CI: 1.2–3.2), illiteracy (AOR = 2.9; 95% CI: 1.4–6.1), unemployed status (AOR = 1.7; 95% CI: 1.1–2.7), and sunlight exposure ≥5 hours per day (AOR = 1.6; 95% CI: 1.04–2.4) were significantly associated with visually significant cataract. Conclusion In this study, visually significant cataract was found to be high, which requires immediate public health intervention.