Objective: To investigate the efficacy of phacoemulsification and small incision extracapsular cataract extraction in the treatment of cataract and their effects on corneal endothelial cells and quality of life. Methods: 203 patients with cataract who were treated in our hospital from March 2015 to June 2017 were selected, according to the random number table method, the patients were divided into the control group with 103 cases and the observation group with 100 cases. The control group was treated with small incision extracapsular cataract extraction, and the observation group was treated with phacoemulsification. The visual acuity of all patients was measured before operation, 1 weeks after operation, 1 months after operation and 3 months after operation. The number of corneal endothelial cells was measured before and 2 weeks after operation, and the cell density and hexagonal cell ratio were calculated. The quality of life was evaluated before and 1 months after operation, and the complications were recorded. Results: There was no significant difference in visual acuity between the two groups before operation, 1 months after operation and 3 months after operation (P>0.05), the visual acuity of the observation group was significantly higher than that of the control group 1 week after the operation (P0.05), the scores of self-care ability, activity ability, social ability and psychological emotion in the two groups 1 months after operation were higher than those before operation(P0.05). Conclusion: Compared with small incision extracapsular cataract extraction, phacoemulsification can improve the vision of patients faster in the short term, and it has less damage to the corneal endothelial cells, however, the short-term effects and complications of the two operations are basically the same, and there is no difference in the quality of life of the patients.