Paediatric cataract is a leading cause of preventable childhood visual impairment in Malaysia. Despite a relatively strong healthcare system, delayed diagnosis and referral, particularly in rural areas, remain major challenges affecting visual outcomes. The condition may be congenital or acquired, with causes including genetic disorders, infections, metabolic diseases, and trauma. Surgical treatment, mainly lens aspiration with or without intraocular lens implantation, is effective, but visual prognosis depends on early intervention and adherence to amblyopia therapy. Malaysian studies show improved surgical outcomes, yet late presentation often leads to irreversible amblyopia. Strengthening screening programs and early referral systems is essential to reduce childhood blindness.