Objective To investigate the prevalence of cataract in Chinese civil aviation pilots and to discuss the aeromedical appraisal.Methods The data of annual ocular examination of pilots from May 2009 to April 2010 were collected.The characteristics of cataract and the follow-up data of 4 waiver cases after cataract extraction combined with intraocular lens implantation were analyzed.Results The cataract prevalence in civil aviation pilots (aged from 21-67 years old) was 0.28％.The prevalence among different age groups had significant difference (x2=217.737,P＜0.01).The cataract positive rate of the pilots older than 40 years old was gradually increased.The opacity mainly located in the lens cortex.The visual function in 4 waiver cases treated by cataract extraction combined with intraocular lens implantation was good.Their safe flying time had been accumulated to 1300-4000 h without discomfort in air since the waiver issued.Conclusion The prevalence of cataract of Chinese civil aviation pilots is low but shows an increasing tendency with age.Cataract pilot who suffered blurred vision,decreased visual acuity and function damage should be temporarily grounded and treated.Special qualification could be considered if pilot's visual function is good,stable and without any complications affecting the flight safety according to 3 month postoperative observation.If the special qualification does not lead to any threads to flight safety and the pilot could keep stable visual function by 3-4 years follow-up,he would get the qualification without limitation.