Background Delayed sequential bilateral cataract surgery (DSBCS) and simultaneous bilateral cataract surgery (SBCS) are the options for bilateral cataract with advantages and attendant complications. No consensus has been reached on the treatment of bilateral cataract. This study investigated the perceptions of patients and cataract surgery providers on the options of SBCS compared with DSBCS in bilateral age-related cataract and factors affecting their preferences. Methods A mixed-method approach of quantitative and qualitative study design was employed. Stratified sampling technique was used to select patients awaiting surgery for bilateral operable cataract, patients who had one eye operated and patients with both eyes operated. All consenting providers of cataract surgery in Lagos state-owned public eye care facilities were also recruited into the study. In-depth interview was conducted among the recruited cataract surgery providers. Quantitative data was analyzed using the Statistical package for Social Sciences (SPSS) while thematic analysis was done for the qualitative data.