Aim- This study was designed to determine the effect of cataract surgery on corneal endothelial cell density in eyes of Nigerian adults with age related uncomplicated cataract, in order to obtain relevant information that will aid in improving cataract surgical outcome, at the National Eye Centre, Kaduna, Nigeria Method – It was a prospective hospital based interventional case study. Two hundred and seventy seven (277) cataract eyes of 269 patients were randomly selected and assigned to either manual small incision cataract surgery (MSICS) or conventional extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC IOL) implantation. Preoperatively the endothelial cell density (ECD), Coefficient of variation (CV), Hexagonality (%), and central corneal thickness (CCT) were measured with a non contact specular microscope. Post operatively these measurements were repeated at 1 week, 4 weeks and 12 weeks respectively.